Many thanks for your question regarding your client with diverticulitis who also experiences a number of additional health concerns and came to see you for help with poor sleep and kidney stones.
You also mentioned that she is suffering with restless leg syndrome which does not appear to have improved on the use of topical magnesium. I also understand she is experiencing heavy menses and is now low in iron.
Her bloating may be linked to hormone changes but could also indicate bacterial dysbiosis. I would therefore consider a comprehensive stool test with parasitology to check for underlying infections. Flare ups are common with diverticular disease and certainly the avoidance of certain foods can be helpful. If she is experiencing a flare up then actually switching to a low fibre diet temporarily can be helpful and focusing on soups, stews, cooked foods that are easier to digest. Some people find foods with seeds or pips can be problematic and tough skins on certain vegetables and fruits.
There are certain foods and nutrients that can be helpful that you may wish to consider
Probiotics: By helping restore the balance of intestinal flora and reduce inflammation in the intestine, probiotic supplementation may be of benefit in both acute and chronic diverticular problems. In addition for diarrhoea the use of Saccharomyces boulardii may be helpful
Tursi A, Brandimarte G, Elisei W, Picchio M, Forti G, Pianese G, . . . Danese S. Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease–a double-blind, randomised, placebo-controlled study. Alimentary pharmacology & therapeutics. Oct 2013;38(7):741-751. http://tinyurl.com/y9ktgblt
Butyrate: In a randomized clinical trial of sodium butyrate in 52 people with diverticular disease, less than 7% of those in the butyrate group experienced diverticulitis symptoms compared with slightly more than 31% in the placebo group.
Krokowicz L, Stojcev Z, Kaczmarek BF, Kociemba W, Kaczmarek E, Walkowiak J, . . . Banasiewicz T. Microencapsulated sodium butyrate administered to patients with diverticulosis decreases incidence of diverticulitis–a prospective randomized study. International journal of colorectal disease. Mar 2014;29(3):387-393. http://tinyurl.com/y8wrojur
Fibre: Supplemental fibre in a form like ground psyllium seed husk or pectin powder can help increase total daily fibre intake. This can also support the production of butyrate which has been shown to be beneficial. Butyrate has been studied as a treatment for diverticular disease
Slavin J. Fiber and Prebiotics: Mechanisms and Health Benefits. Nutrients. 2013;5(4):1417-1435. http://tinyurl.com/yad7bbde
Fish oil: Due to its anti-inflammatory properties – the use of fish oils may be helpful as well as other anti-inflammatory agents including curcumin. Studies in animal models of IBD have shown that curcumin can inhibit tumor necrosis factor-alpha, one of the inflammatory chemical messengers associated with diverticular disease and acute diverticulitis
Tursi A, Elisei W, Giorgetti GM, Inchingolo CD, Nenna R, Picchio M, . . . Brandimarte G. Expression of basic fibroblastic growth factor, syndecan 1 and tumour necrosis factor alpha in resected acute colonic diverticulitis. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. Mar 2014;16(3):O98-103. http://tinyurl.com/y79ux5z2
As your client is low in iron you may wish to suggest she takes a liquid iron such as SPA TONE and retest in 4-6 weeks. This may also help with her restless legs syndrome as well. You mentioned that reflexology has helped her restless legs but you may also wish to look at using folate.
Patrick L. Restless Legs Syndrome: Pathophysiology and the Role of Iron and Folate. Alternative Medicine Review, 2007; 12. http://tinyurl.com/h6ov8h4
As diabetes is a risk factor for restless legs you may wish to run some blood tests to check her insulin and blood glucose handling. Magnesium supplementation has been studied as a treatment for RLS. One case study found that magnesium supplements were able to relieve symptoms of RLS and improve sleep – so a supplement perhaps combined with calcium and potassium may be more effective.
Hornyak M, Voderholzer U, Hohagen F, Berger M, Riemann D. Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study. Sleep 1998;21. http://tinyurl.com/y9eqo2q2
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
KappArest (BRC) take 2 with each meal http://tinyurl.com/jms9v3n
EFA Sirt Supreme (BRC) take 2 three times daily http://tinyurl.com/h3czc9x
Probiotic and prebiotic support
Bio Doph 7 Plus (BRC) take 2 daily http://tinyurl.com/hs3vsyr
Saccharomyces boulardii (ARG) take 2 three times a day http://tinyurl.com/z27sdwn
IAG powder (BRC) take 1tsp twice daily http://tinyurl.com/jl6rsek
CMP (BRC) – take 2 twice daily http://tinyurl.com/y9xr5o9t
Bio 3GB (BRC) take 2 with each meal
I hope this helps with your client
Registered Nutritional Therapist Helen Perks is collaborating with Clinical Education to bring you the first-ever Functional Medicine book club for Practitioners.
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