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The types of complementary or alternative therapies that may specifically help in diverticular disease are:

acupuncture

• naturopathy

• homoeopathy

aromatherapy

• reflexology

relaxation therapy

Even though these therapies may offer the patient help or relief from symptoms, they do not replace western orthodox medicine when there are associated complications in diverticular disease, such as haemorrhage, fistula, obstruction and abscess.

Often daily ingestion of 'live bacteria' in the form of Acidophilus, Bifidus and Lactobacillus, in yoghurt, yoghurt drinks (Actimel, etc.) or capsule form, will alleviate the symptoms of flatulence and discomfort after a meal. The action of the live bacteria is to help prevent the unwanted bad bacteria infesting the gut, which can happen if antibiotics have been taken for a flare-up of diverticulitis.

Often constipation aggravates diverticular disease and GPs will prescribe isphagula husk (Fybogel) although it is often not effective and contains additives. A natural way to help the bowel work is to have fruit, particularly papaya, prunes or figs, mixed with cereal or porridge. Herbal tea infusions also help. Pure bran should not be added to food because it is very hard for the gut to break it down (see Chapter 11). If the gut is sensitive during or after an attack of diverticulitis or there is infection or bleeding from the rectum, bland food such as chicken and fish and plain pasta and plenty of water to drink will help until symptoms subside. Red meat, fatty foods and pastries should be avoided. Often the removal of wheat-based products and dairy products from the diet gives some relief and along with caffeine-based drinks and fizzy drinks can bring long-term relief.

In a Danish study (Tonnesen et al., 1999) investigation was made between the association of alcohol and diverticulitis. The study followed a large cohort of men and women discharged from the hospital with the diagnosis of alcoholism between 1977 and 1993. The risk period was defined as from the date of admission to the first hospital diagnosis of diverticulitis, to death or to the end of 1993.

It appears that the risk of diverticulitis was significantly increased in people with alcohol problems, with it being slightly higher in women than in men. Although the aetiology of diverticulitis is unknown, it may be that immunocompromising mechanisms are important. It is known that alcohol can suppress the immune capacity and may be relevant in the risk of diverticulitis in those who abuse alcohol. It is known that ethanol can suppress a variety of T-cell-dependent processes. Other factors often related to alcoholism are malnutrition and smoking. The outcome of the study postulated that the high incidence of diverticulitis may be another complication of alcohol abuse, with increased postoperative morbidity when surgical intervention is needed.

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