High fiber diet in diverticular disease

by Dr. Lazowski

Diverticulitis is a common condition affecting the large bowel. It is caused by pouches that are formed in the bowel wall that can be inflamed leading to a condition called diverticulitis. Those patients need to be treated with antibiotics and are at risk for surgery because of abcess formation. Diet can help to reduce the episodes of inflammation, and high residue diet such as nuts, seeds and popcorn needs to be eliminated. It is thought that those food particles can enter, block and irritate the diverticulum that might lead to flares of inflammation. Those recommendations were recently called to question. American Society of Colon and Rectal Surgeons did not mention of avoidance of nuts and popcorns for the prevention of diverticulitis in the most recent practice parameters. High residue diet including fiber might be beneficial in reducing further episodes of diverticulitis. Several retrospective studies in patients with symptomatic diverticulosis and diverticulitis showed decreases in symptoms and decreases in progression to a more complicated disease. In fact high fiber diet is recommended by the National Digestive Disease Clearinghouse patient portal for patients with diverticular disease.   It looks that at this time fiber might be helpful in patients with diverticular disease and avoidance of seeds, popcorn and nuts might not be required. (Am J Gastroenterol. 1999 Nov;94(11):3110-21) (Internalmedicinenews.com, Sep 1, 2015, 21)