DR MEGAN ROSSI: The secret to age-proofing your gut

We spend a fortune on products to tackle wrinkles and grey hair, and there is always plenty to read about what you can do to look younger.

Our guts also age, but we often don’t think about this until the symptoms strike in their joyless way.

The classic example is diverticular disease — which is something quite a few of you have written to me about (don’t forget, you can contact me at the address at the bottom of this page with any gut‑related or dietary questions).

Basically, diverticular disease starts with a weak spot in the intestine, usually the lower part of your colon called the sigmoid colon. This pushes out, forming a small pouch (with a narrow opening) that’s usually no bigger than a pea. This pouch, or pocket, is known as a diverticulum.

Most people — around 70 per cent of us by the time we hit our 80s — develop at least one diverticulum, due to the weakening of the intestine.

But it’s actually no longer ‘just’ a problem of ageing, as more younger people are developing them (I’ll explain why later).

Medically speaking, this condition is known as diverticulosis, but the majority of people who have it wouldn’t know because it causes no symptoms.

Often diverticulosis is only spotted because someone is having their gut scanned for other reasons. In fact, the condition tends to be the most common finding in a colonoscopy (where a tiny camera is inserted via your bottom).

However, as many as 20 per cent of people with diverticulosis experience problems, ranging from bloating, changes in stool habits and cramping, to more severe symptoms, including stabbing pains, nausea and vomiting.

The milder symptoms can often be confused with irritable bowel syndrome (IBS). But while there is some overlap, in contrast with IBS, the pain caused by diverticular disease is typically prolonged (lasting more than 24 hours) and in the left lower part of your gut.

If you do experience these symptoms, it’s worth talking to your GP. (Just to get technical, if you have symptoms, your diverticulosis is then classified as diverticular disease.)

In a small proportion of cases —around 5 per cent of people with diverticulosis — the pockets become inflamed.

This causes acute abdominal pain, diarrhoea and fever, and, in severe cases, abscesses or tearing of the intestinal wall, with symptoms such as rectal bleeding (a sign that one of the pockets has burst, rupturing a blood vessel).

The standard treatment for this condition, known as diverticulitis, is a course of antibiotics, as the inflammation is often due to microbes invading and irritating the pockets.

Now, you might have heard that diverticula are a sign of a lack of fibre in the diet; the idea is that hard stools caused the pockets.

In fact, we now know that a lack of fibre is just one component in a complex mix of factors behind diverticulosis, including lifestyle, genetics and gut bacteria — yes, them again!

This is because when gut bacteria break down food, they produce a compound called butyrate that helps to fuel and strengthen our gut lining.

Constipation, inflammation (linked to smoking and being overweight) and type 2 diabetes are also risk factors for developing these pockets, which might help explain why we’re seeing more younger people with diverticulosis.

With type 2, one theory is that it affects the blood flow (and, therefore, tissue health) and movement through the gut.

So the big question is: what can you do to prevent diverticula forming; or if you already have diverticular disease, how do you prevent a flare-up (i.e. diverticulitis)?

Of course, genetics you can’t do much about, but including more plants in your diet, avoiding constipation (see below), taking regular exercise and cutting out smoking will help maintain a healthy gut lining and, therefore, help lower your risk of these pouches forming.

In terms of preventing diverticulitis, keeping your bowels moving regularly and preventing constipation are even more important.

A diet high in fibre from fruits, vegetables and wholegrains is thought to protect against it by increasing the size of your poop and the speed it passes through, as well as softening it, all of which reduce the pressure on the wall of your intestine.

Many of my clients with diverticular disease have found that establishing a morning routine that encourages healthy bowel movement has been key to preventing flare-ups.

This routine typically includes a morning cup of coffee (which gives their gut a gentle kickstart), a few tablespoons of psyllium husk or flaxseeds in their oats (see my overnight oats recipe, above) and doing some gentle exercise after breakfast (ten minutes of yoga or a brisk walk around the block).

Historically, there was a belief that people with diverticular disease should avoid nuts, seeds and popcorn. In fact, this is based on nothing more than a theory that, because these foods often arrive in the colon undigested, they could get caught in a diverticulum.

The good news for all the nut, seed and popcorn-lovers out there is that there’s no actual evidence to support this.

In the case of diverticulitis, your GP and dietitian may advise on a short-term, lower-fibre diet.

But once the inflammation is resolved, you actually want a high‑fibre diet — so nuts, seeds and popcorn are certainly back on the menu.

Try this:  Carrot cake overnight oats

There is something comforting about going to bed knowing that millions of microbes will continue working through the night, transforming your breakfast into a flavour-infused jar of goodness. This recipe not only provides good bacteria, but a sizeable 8g of fibre per portion — and it really does taste like you’re having carrot cake for breakfast.

Serves 2

• 45g rolled oats
• 1 tsp mixed seeds
• 1 tbsp flaxseeds
• 1 tbsp desiccated coconut
• 1 extra-ripe banana, mashed (100g peeled weight)
• 50ml live, no-added sugar yoghurt
• 200ml milk of your choice
• 1 Medjool date, thinly chopped, or sweetener of your choice
• 40g carrot, grated
• 1 tbsp walnuts, crushed l ½ tsp cinnamon 

Combine all the ingredients in a mixing bowl and stir well. Divide into two 300ml jars and cover with their lids, then leave out on the worktop for up to four hours for the microbes to work their magic.

Stir through before popping in the fridge to chill overnight. Breakfast is served!

Options

Not ready for fermenting? Replace the yoghurt with your milk of choice and pop straight in the fridge.