Q. My Dad has bleeding diverticulitis. What are the long-term effects of this illness?
And what changes does he need to make to his diet to prevent flare-ups?
His current diet is as follows: porridge made with water and tea in morning with sugar to taste; at 10am he has white bread toasted; 1pm white bread again and tea, maybe sausages; 4pm he may have tea and more bread; at 6pm he has his dinner of red meat and potatoes. He is not great on veg but he has stopped eating chocolate.
A. One of the main causes of diverticulitis is a diet lacking in fibre — so your father’s dislike of fruit and vegetables is definitely an issue worth tackling.
What happens when you aren’t getting enough roughage through your diet, is that the stools become small and hard, leading to a longer transit time and hence more pressure to move through the bowel. This increase in pressure can trigger the formation of small pouch-like sacs along the lining of the small and large intestines.
Once these diverticulae have formed, undigested food can become trapped in these sacs — which results in bacterial infection and inflammation. As you can imagine, a history of chronic constipation is often a precursor to this condition. The bleeding is due to the blood vessels in the muscle layer of the bowel breaking open.
It is common in this condition to have bleeding with a bowel movement, however if your Dad presents with a significant amount of blood in his stool, it is important that he see a doctor immediately.
As far as dietary changes go, it is crucial to introduce fruit and vegetables, with the exception of potentially irritating tomatoes and citrus. He should avoid nuts and seeds, as they are likely to exacerbate this condition.
When dealing with intestinal issues, it is a good idea to strip the diet back to that which you would feed a small child. In this way, we can repair the gut with simple foods.
Foods can either be blended, or they must be well-cooked and thoroughly chewed before swallowing. Broccoli, beans, and carrots are great as they contain hemicellulose fibres which absorb water, bulking and softening waste as it travels through your system.
If your father cannot be convinced as to the benefits of adding more produce to his diet, then a soluble fibre supplement, such as psyllium husks, might be best. He will need to take a heaped teaspoon each morning and night in around 300ml of water, working up to a tablespoon twice daily.
Q. I am in my late-70s and suffer from a swollen left ankle and in-step. My doctor tells me it is fluid retention but did not prescribe any medication. What do you suggest?
A. Fluid retention in the ankles and feet can have a number of causes, however — given your age — it is likely that circulation is a significant factor. If you are carrying excess weight, then this will also contribute, as will smoking cigarettes.
Ginger is wonderful for improving circulation — simply pop a couple of slices of fresh ginger root in a cup of boiling water and steep for five to six minutes, adding honey to taste. You can reuse the ginger slices throughout the day to make three to four cups.
To relieve the fluid retention itself, yarrow tea is brilliant. It is important to remember that this tea must be taken cold to have a diuretic effect — if you take it hot, then it will act as a diaphoretic and make you perspire more.
Elevate your legs whenever possible, remembering not to cross your legs (this limits the blood flow from the thighs, which will aggravate swollen ankles), avoid tight clothing, and ensure you set aside time throughout the day to move your arms and legs.
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