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What is it?

  • Colonic diverticulosis is the condition whereby diverticula, or pockets, form from the lining of the colon. These protrusions of the colon lining occur at sites of weakness in the muscle wall possibly due to increased pressure from muscle contractions.
  • Diverticulitis is an inflammatory process that causes acute symptoms and may be associated with serious complications.

What may cause it?

  • Potential risk factors include increasing age; diets low in fibre, high in red meat and refined carbohydrates; obesity.
  • There is no evidence that seeds or nuts cause diverticulitis.
  • Changes in the biodiversity of the colonic bacteria

What are the symptoms?

  • Diverticulosis is often asymptomatic and found on investigation by colonoscopy or CT scanning. It may be associated with low abdominal cramping, bloating or constipation.
  • Diverticulitis, due to infection or inflammation of the diverticula, may cause localized lower left sided abdominal pain with either diarrhoea or constipation and fever. Bleeding may occur.

How common is it?

  • Classically, this is a disease process that predominantly affects people over the age of 70 years and is more common in developed countries. It is however getting more common in younger people possibly related to obesity.

What tests are needed to diagnose it?

  • A colonoscopy enables the gastroenterologist to examine the lining of the colon to confirm diverticulosis and to exclude colon cancer or inflammatory bowel disease.
  • An abdominal CT scan is a radiological test used to diagnose diverticulitis and to look for complications.
  • A blood test may be performed to look for any signs of infection or inflammation within the colon.

How do you treat it?

  • Individuals with diverticulosis are advised to eat a healthy and balanced diet, avoid too much red meat and to lose weight if obese. Use of a prebiotic and/or a probiotic may be of benefit but at present this is an evidence-free zone.
  • Mild diverticulitis is usually treated with oral antibiotics. A recent placebo-controlled trial however did not show, in the outpatient setting, that antibiotics were any better than placebo.
  • Patients with complications of acute severe diverticulitis such as an abscess (collection of pus) or perforation (a hole in the colon) require emergency admission to hospital for intravenous antibiotics and sometimes urgent surgery.
  • Long-standing severe diverticulosis or following recurrent attacks of diverticulitis the colon may get narrowed (stricture formation) and surgery may be required to avoid obstruction.

If you have any questions, please do not hesitate to contact Dr. Harris.



Studies conducted in recent years have explored the relationship between the gut microbiota, consisting of around 800 different bacteria species, and metabolism. It has been suggested that specific intestinal microbial compositions can either protect from, or contribute to, obesity and other metabolic diseases.

First, I would like to discuss short-chain fatty acids (SCFA) and the vital role they play in influencing gut health. SCFA are produced by bacteria from fermentation of dietary products, mostly fibre, within the colon. Their primary role is to serve as a source of energy for cells within the colon and to stimulate repair and replacement. Of potential interest, butyrate may influence how energy (including glucose) is metabolised in the body and so hold a possible protective effect against metabolic disease and obesity.

The potential relationship between gut microbiota and obesity was analysed in this excellent 2017 study when faecal microbiota from both lean and obese subjects was transferred into mice, which then changed their feeding behaviour and subsequently their body mass to reflect the human source. The researchers suggested that butyrate positively influences energy balance and thus protects from diet-induced obesity.

Subsequent research has shown a broad variety of possible effects of butyrate on metabolism including an increase in mitochondrial activity, preventing metabolic endotoxemia, improving insulin sensitivity, increasing intestinal barrier function and protecting against diet-induced obesity.

These fascinating findings suggest a relationship between the gut microbiota and human metabolism. Further research is needed in humans to extend the experimental findings in mice and to establish if the gut microbiome may be changed (by prebiotics, probiotics, antibiotics or even faecal transplantation) to help reduce obesity and even, diabetes.

If you have any questions about gut microbiota and its relationship to obesity, please do not hesitate to contact Dr. Harris



In the 19th edition of the Gut Reaction series, I suggested that patients with Laryngo-Pharyngeal Reflux (LPR) may consider an alkaline water & plant-based Mediterranean style diet. As discussed in that blog, a paper published in JAMA Otolaryngology (October 2017) suggested that diet and consumption of alkaline water might be as effective as treatment with a PPI. The main outcome of the study was a change in Reflux Symptom Index (RSI) – the 1st group were treated with PPI and standard anti-reflux precautions (PS) and the 2nd group with alkaline water, a plant-based Mediterranean-style diet and standard anti-reflux precautions (AMS). Results from the study showed that the percentage of patients achieving a clinically meaningful reduction in RSI was 54% in PS-treated patients and 63% in AMS-treated patients.

How alkaline water and dietary change help the symptoms of LPR is unclear but it may change the biodiversity of the gut bacteria (microbiome) in the oro-pharynx, gullet (oesophagus) and stomach.

In this blog, I will provide some further information regarding alkaline water and what the Mediterranean-style diet involves.

First of all, the “alkaline” in alkaline water refers to its pH level. The pH level is a number that measures how acidic or alkaline a substance is on a scale of 0 to 14. Alkaline water has a higher pH level than regular drinking water. Because of this, some advocates of alkaline water believe it can help maintain balance by neutralising the acid in your body. Drinking water generally has a neutral pH of 7 while alkaline water typically has a pH 8-9.

It is relatively straightforward to make your own alkaline water at home. Here is a suggested recipe:

  • Pour a half-gallon of the filtered water (preferable to tap water) into a gallon jug with a lid. If using tap water, a filtration system is recommended.
  • Add one teaspoon each of baking soda, sea salt and coral calcium powder to the container.
  • Wash a lemon and slice it in half. Squeeze the juice into a small bowl.
  • Pour the juice into the water/baking soda/coral calcium mix.
  • Secure the container lid and then shake it vigorously to thoroughly mix all the ingredients.
  • Add the rest of the distilled water to the container, being sure to leave an inch of space at the top of the container for air.
  • Close the container tightly and shake it to mix the water.
  • Use pH strips to test the water to see the level, ideally around level 8 or 9. If that is not the case, add another ¼ teaspoon of baking soda and mix again until the proper pH level is reached.

Equally, many supermarkets stock alkaline water along with other specialty waters in the bottle water aisle. It can also be ordered online from a number of retailers.

Here is some basic information about the plant-based Mediterranean style diet:

  • Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts.
  • Replace butter and other dairy with healthy fats such as olive oil and canola oil.
  • Use herbs and spices instead of salt to flavour foods.
  • Limit red meat to consume no more than a few times a month.
  • Eat fish and poultry at least twice a week.

If you have any questions about alkaline water or a plant-based Mediterranean style diet, please do not hesitate to contact Dr. Harris.



At West Kent Gastroenterology, we work hard to provide our patients with top-class care. You will enjoy friendly, fast and modern treatment by a highly experienced gastroenterologist. We carefully review patient satisfaction and feedback, and at West Kent Gastroenterology we are continuously making improvements to our services, ensuring the highest level of care possible.

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Kingswood Road, Tunbridge Wells, TN2 4UL

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Fordcombe Road, Tunbridge Wells, Kent, TN3 0RD

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