Diverticulosis - What to Eat

Diverticulosis, otherwise known as diverticular disease is the condition of having outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. Diverticuli develop in the majority of people in industrialized societies as they get older, most likely due to the absence of fiber in their diets. About 10% of the US population over the age of 40 and half over the age of 60 has diverticulosis. Minute ruptures occur in the wall of the large intestine, which can become inflamed and infected, a condition called diverticulitis. These infections are painful and can eventuate in perforations or abscesses. Hospitalization for antibiotics or surgery may be necessary.

For many years doctors have told their patients with diverticulitis not to eat nuts or seeds, or any foods containing seeds, as if those bits of food would lodge in their intestinal outpocketings and cause infection or perforation. An article in the journal of the American Medical Association (JAMA, 2008; 300:907-914), puts that argument to rest.

It was thought that nuts or small seeds, even soft ones from tomatoes or cucumbers, could get stuck inside these diverticuli and cause obstruction and infection. It turns out that instructions to avoid such foods have been completely wrong. Nuts, seeds, and even popco
do not worsen diverticulitis, but seem to prevent it by providing fiber.

The best instructions to prevent diverticulitis are to increase the intake of high fiber foods, meaning fruits and vegetables, nuts and seeds. The more fiber, the less likely inflammation and infection will occur.

• Allan Sosin, MD

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