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Dr. Shustina is an incredibly knowledgeable doctor who truly takes time to find root cause.
RG
Rochel Gordon
Condition · General & Women’s
Diverticular Disease (Diverticulosis & Diverticulitis)
Small pouches bulging from your colon wall, occasional bleeding, and the constant worry of when inflammation might strike aren't just normal aging—they're signs of diverticular disease, a condition affecting over 50% of adults over age 60 in Western countries. Research shows dramatic geographic differences in this "Western disease," with rates 10-50 times higher in developed countries compared to Asia and Africa, highlighting the crucial role of diet, lifestyle, and gut health in both prevention and management. Our comprehensive approach addresses the root causes while providing targeted treatment for both asymptomatic diverticulosis and acute diverticulitis episodes.
What Exactly Is Diverticular Disease?
Diverticular disease encompasses a spectrum of conditions involving small, sac-like protrusions (diverticula) that develop in weak areas of the colon wall. Diverticulosis refers to the presence of these pouches without symptoms, while diverticulitis occurs when they become inflamed or infected. This "Western disease" primarily affects the sigmoid colon in European and American populations, but involves the right colon in Asian populations, suggesting genetic and dietary factors play crucial roles. Effective management requires understanding the underlying mechanisms—including increased colonic pressure, wall weakness, altered motility, and microbiome imbalances—rather than simply managing acute episodes.
Types of Diverticular Disease and Their Characteristics
Diverticular disease exists on a continuum from asymptomatic pouches to life-threatening complications, each requiring specific management approaches and prevention strategies.
| Type | Primary Characteristics | Common Symptoms | Considerations |
|---|---|---|---|
| Asymptomatic Diverticulosis | Silent pouches without inflammation | Usually no symptoms | Found incidentally; 75% remain asymptomatic |
| Symptomatic Uncomplicated Diverticular Disease (SUDD) | Chronic symptoms without acute inflammation | Abdominal pain, bloating, altered bowel habits | Often involves chronic low-grade inflammation and microbiome changes |
| Uncomplicated Diverticulitis | Acute inflammation without complications | Severe left lower abdominal pain, fever, nausea | 80% respond to conservative treatment |
| Complicated Diverticulitis | Inflammation with abscess, perforation, or obstruction | Severe pain, high fever, signs of complications | May require hospitalization, antibiotics, or surgery |
Why Diverticular Disease Impacts More Than Digestion
Diverticular disease affects multiple body systems due to chronic inflammation, altered gut microbiome composition, and the potential for serious complications. Research shows that people with diverticular disease have decreased beneficial bacteria that produce short-chain fatty acids, leading to compromised gut barrier function and systemic inflammation. This can contribute to immune dysfunction, increased infection risk, and poor nutrient absorption. Additionally, the chronic pain and unpredictability of diverticulitis episodes can significantly impact mental health, sleep quality, and overall quality of life, while the fear of complications affects dietary choices and social activities.
Common Signs of Diverticular Disease Include
Diverticulosis (Often Asymptomatic):
- Usually no symptoms in 75% of people
- Mild abdominal cramping or discomfort
- Occasional bloating or constipation
- Rare rectal bleeding (usually painless, can be significant)
Symptomatic Uncomplicated Diverticular Disease:
- Chronic left lower abdominal pain (right-sided in Asian populations)
- Intermittent bloating and distension
- Altered bowel habits (constipation or diarrhea)
- Feeling of incomplete evacuation
- Food intolerances or sensitivities
Diverticulitis:
- Severe, constant left lower abdominal pain
- Fever and chills
- Nausea and vomiting
- Changes in bowel habits
- Abdominal tenderness
- Loss of appetite
- Urinary symptoms (if affecting adjacent structures)
Diagnostic Options at Whole Gut Health
Comprehensive diverticular disease evaluation involves both acute assessment and long-term prevention strategies. At Whole Gut Health, we use advanced diagnostics to assess disease severity, identify complications, and develop personalized management plans.
Testing options may include:
CT Scan with Contrast - The gold standard for diagnosing diverticulitis and assessing complications like abscesses or perforation.
Comprehensive Stool Analysis to assess gut microbiome composition, inflammation markers, and digestive function.
Inflammatory Markers including C-reactive protein and complete blood count to assess acute inflammation.
Applied Kinesiology or Muscle Testing to help guide root cause and treatment.
Functional Lab Work including nutrient assessments, immune function evaluation, and metabolic markers.
We customize diagnostic protocols based on your presentation, disease history, and risk factors to ensure comprehensive evaluation and optimal management planning.
Our approach
Why Whole Gut Health is different
At Whole Gut Health, we go beyond conventional symptom management and traditional functional medicine protocols. We trust your body's innate ability to heal itself when given the right support.
In Dr. Shustina's many years of practice, she has seen that many digestive diseases have their root cause in emotional traumas and unhealed wounds. When these underlying causes are healed, the body can heal from the inside out in a lasting way.
We focus on the mind-gut connection, incorporating energy healing techniques, personalized nutrition that evolves as you heal, and integrative approaches addressing mind, body, and spirit. If this resonates with you, contact our office to schedule your consultation and take the first step on your healing journey.
Our SIBO Treatment Approach
Our Three-Phase Diverticular Disease Protocol Includes:
Phase 1 — Assessment and Risk Stratification
- Comprehensive evaluation of disease type, severity, and complications
- Detailed analysis of dietary, lifestyle, and genetic risk factors
- Gut microbiome imbalances and inflammatory patterns
- Dietary triggers and fiber intake patterns
- Medication effects (NSAIDs, opioids, steroids)
- Underlying conditions affecting colon health
- Family history and genetic predisposition
- Dietary Optimization: Personalized fiber recommendations, anti-inflammatory nutrition, and trigger food elimination
- Energy Medicine: Helping manage the stress and emotional triggers causing constipation.
- Medication Review: Assessment and modification of medications that increase diverticular disease risk
Phase 2 — Targeted Intervention
- Lifestyle factors (exercise, smoking, stress)
- Acute Management: Anti-inflammatory protocols, targeted antimicrobials when indicated, and symptom relief strategies
- Visceral Manipulation: Helping restore normal gut motility and improve constipation.
- Gut Microbiome Restoration: Targeted probiotics and prebiotics to restore beneficial bacteria and reduce inflammation
Phase 3 — Rebuilding and Prevention
- Lifestyle Modifications: Exercise protocols, stress management, and smoking cessation support
- Comprehensive Prevention Strategies: Sustained dietary modifications and lifestyle optimization to prevent recurrence
- Ongoing Microbiome Support: Long-term protocols to maintain healthy gut bacteria composition
- Regular Monitoring: Surveillance strategies and early intervention protocols for symptom changes
- Complication Prevention: Education and support to recognize warning signs and prevent serious complications
- Quality of Life Optimization: Strategies to manage chronic symptoms and maintain active lifestyle
Expert-Led, Personalized Care
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist specializing in complex digestive disorders, gut health, and the gut–brain connection. Drawing from both conventional gastroenterology and integrative medicine, she takes a comprehensive approach to uncovering the underlying factors contributing to illness and guides patients toward lasting wellness.
At Whole Gut Health, every patient receives highly personalized care rooted in a deep understanding of digestive health, nutrition, the gut microbiome, and the interconnected systems that influence overall well-being. By combining evidence-based medicine with a thoughtful, individualized approach, we help patients move beyond symptom management and create a clear path toward long-term healing and vitality.
Frequently Asked Questions
Common questions, answered
What is diverticular disease?
+
Diverticular disease encompasses a spectrum of conditions involving small, sac-like protrusions (diverticula) in the colon wall. Diverticulosis refers to the presence of these pouches without symptoms, while diverticulitis occurs when they become inflamed or infected. The disease exists on a continuum from asymptomatic pouches to potentially life-threatening complications.
What are the different types of diverticular disease?
+
Asymptomatic Diverticulosis
- Primary characteristics: Silent pouches without inflammation
- Common symptoms: Usually no symptoms
- Found incidentally; 75% remain asymptomatic
Symptomatic Uncomplicated Diverticular Disease (SUDD)
- Primary characteristics: Chronic symptoms without acute inflammation
- Common symptoms: Abdominal pain, bloating, altered bowel habits
- Often involves chronic low-grade inflammation and microbiome changes
Uncomplicated Diverticulitis
- Primary characteristics: Acute inflammation without complications
- Common symptoms: Severe left lower abdominal pain, fever, nausea
- 80% respond to conservative treatment
Complicated Diverticulitis
- Primary characteristics: Inflammation with abscess, perforation, or obstruction
- Common symptoms: Severe pain, high fever, signs of complications
- May require hospitalization, antibiotics, or surgery
What are the common signs and symptoms of diverticular disease?
+
Diverticulosis: Usually no symptoms in 75% of people, mild abdominal cramping, occasional bloating, rare rectal bleeding
Symptomatic Uncomplicated Disease: Chronic left lower abdominal pain, intermittent bloating, altered bowel habits, feeling of incomplete evacuation, food intolerances
Diverticulitis: Severe constant left lower abdominal pain, fever and chills, nausea and vomiting, changes in bowel habits, abdominal tenderness, loss of appetite
How is diverticular disease diagnosed?
+
Comprehensive evaluation involves multiple approaches depending on presentation:
- CT Scan with Contrast: Gold standard for diagnosing diverticulitis; assesses complications like abscesses or perforation
- Applied Kinesiology or muscle testing which helps guide root cause and treatment.
- Comprehensive Stool Analysis: Assesses gut microbiome composition and inflammation markers
- Food Sensitivity Testing: Identifies dietary triggers contributing to inflammation
- Inflammatory Markers: Including C-reactive protein and complete blood count
Diagnostic protocols are customized based on presentation and disease history.
What does diverticular disease treatment involve?
+
Our comprehensive three-phase protocol includes:
Phase 1: Assessment and Risk Stratification
- Comprehensive evaluation of disease type, severity, and complications
- Detailed analysis of dietary, lifestyle, and genetic risk factors
- Assessment of contributing factors including gut microbiome imbalances, dietary triggers, medication effects, and lifestyle factors
Phase 2: Targeted Intervention
- Acute management with anti-inflammatory protocols and symptom relief
- Dietary optimization with personalized fiber recommendations and anti-inflammatory nutrition
- Visceral Manipulation helps restore normal gut motility and improve constipation.
- Energy Medicine helps manage the stress and emotional triggers causing constipation.
- Gut microbiome restoration with targeted probiotics and prebiotics
- Lifestyle modifications including exercise protocols and stress management
- Medication review and modification when appropriate
Phase 3: Long-Term Prevention and Maintenance
- Comprehensive prevention strategies with sustained dietary and lifestyle modifications
- Ongoing microbiome support to maintain healthy gut bacteria
- Regular monitoring and surveillance strategies
- Complication prevention education and early intervention protocols
- Quality of life optimization strategies
Why is it important to identify the specific type of diverticular disease?
+
Different types require different management approaches:
- Asymptomatic diverticulosis focuses on prevention strategies
- SUDD requires microbiome restoration and anti-inflammatory approaches
- Uncomplicated diverticulitis needs acute management and recurrence prevention
- Complicated diverticulitis may require immediate medical intervention and long-term monitoring
Can diverticular disease be prevented or managed without medications?
+
Yes, many cases can be effectively managed through comprehensive lifestyle approaches including:
- Anti-inflammatory dietary modifications
- Gut microbiome optimization
- Regular exercise and stress management
- Smoking cessation and medication review However, acute diverticulitis may require medical treatment, and our approach focuses on reducing the need for long-term medications through root-cause management.
What makes your approach to diverticular disease treatment different?
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At Whole Gut Health, we address both acute management and long-term prevention through:
- Comprehensive assessment of underlying causes and risk factors
- Integration of conventional gastroenterology with functional medicine approaches
- Gut microbiome restoration and anti-inflammatory protocols
- Personalized dietary and lifestyle optimization
- Focus on preventing complications and recurrence rather than just managing acute episodes
Who provides diverticular disease care at your practice?
+
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist who serves as Miami's premier gut health specialist. She has training in both conventional gastroenterology and functional gut health, with expertise in the gut microbiome and its role in health and wellness.
How do I get started with diverticular disease care?
+
The first step is scheduling a comprehensive consultation where we'll:
- Review your symptoms, medical history, and any previous diverticular episodes
- Determine the most appropriate diagnostic and treatment strategy for your case
- Develop a personalized management plan focused on both immediate needs and long-term prevention
Contact our office to schedule your initial consultation and begin your comprehensive approach to diverticular disease management and prevention.
Reviews
The body remembers when it's finally heard
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Dr. Shustina goes to the root level of the issue, not only superficial, so there's healing.
LG
Leah Glickman
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She has significantly improved my health. I was suffering from Ulcerative Colitis and now live normally.
ML
Monica LaBadia
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Dr. Shustina has helped me change my lifestyle and heal my gut in a way I thought impossible.
DL
Dalit Lonstein
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She listens to patients and treats conditions, not symptoms.
GS
Gabriela Salazar
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Dr. Shustina is the best doctor I have ever been to. She assesses the root of the problem.
MS
M. S.
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She is an outstanding doctor who understands the body's ability to heal itself and holistic remedies.
SS
Sibel Sebi Sharabi
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Dr. Shustina has a wealth of knowledge and is helping me heal years of gastrointestinal issues.
DC
Daniela Chaparro
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Dr. Shustina is an amazing doctor. She diagnosed my cancer early and saved my life.
MW
Mordechai Weinstein
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After one session with Dr. Shustina, my digestive pain went away.
TP
Taryn Parascand
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Doctor Shustina is the absolute best. She has helped me resolve numerous issues other doctors dismissed.
RS
Rachel S.
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Dr. Shustina is a fantastic doctor who truly cares. Her holistic approach attacks the root cause.
CS
Clay Simonsen
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