The colon or large intestine has a muscular layer running along its length and bands of muscle that circumvent it. In combination, these muscles contract to form peristaltic waves that push the faeces onwards towards the rectum before expulsion.

Weakness in the intestinal muscles causes diverticular, small bulges in the intestinal lining to protrude. This may lead to inflammation and the discomfort associated with diverticulosis.

A tendency to weakness along the muscle wall, either hereditary or due to a prolonged low-fibre diet which does not allow the bowel to exercise its muscle and keep it firm, lets small pouches of the mucosal lining to protrude through the muscular layer in a form of herniation.

This condition may be symptomless or cause mild discomfort. If faeces get trapped in the diverticula it will cause swelling and inflammation, which in turn can lead to infection. When this occurs the condition is known as diverticulitis.

Diverticulosis may need no attention but diverticulitis, which is characterized by much stronger cramping pains, tenderness on palpation, a tendency to alternate between diarrhoea and constipation and, rarely, bleeding, needs to be dealt with effectively. Prolonged and untreated diverticulitis can lead to colon abscesses with the risk of perforation and peritonitis. These are serious and potentially fatal conditions. A fever associated with these symptoms should sound alarm bells because it is probable that infection has set in.


Establishing the diagnosis of any abdominal pain should be done by a GP. A suspicion of diverticulosis or diverticulitis may lead to further investigations, such as ultrasound, barium enemas and colonoscopy. As always, whatever precautions can be used to protect against investigation should be reviewed in the relevant section, but diagnosis is important when treating abdominal conditions.

Discuss your diet with a nutritionist, paying special attention to increasing fibre. The orthodox world is quick to encourage the use of bran or other specially extracted fibre but this tends to bind salts and electrolytes such as calcium and magnesium that are necessary for strengthening bowel muscle and is therefore not as effective as natural fibre from fruit and vegetables.

Avoid any herbal treatments that may encourage bowel motivity because this may worsen symptoms.

Diverticulosis/itis is often associated with dehydration and adequate fluid intake is essential.

The juice of two carrots, two celery stalks and three ounces of cabbage made up to half a pint of fluid with water should be taken after breakfast.

Homeopathic and herbal medicine can be used based on the symptoms but are best prescribed by specialists in the field.

Ensure the use of a good Acidophilus or other yoghurt-based bacterial combination taken with each meal. Correction of any abnormal bowel flora can be rapidly beneficial.