DEAR DR. GOTT: I am a relatively healthy 48-year-old nurse with no history, no meds and no allergies. I developed severe abdominal pain and was diagnosed with diverticulitis. I knew immediately, as I have been preaching to my patients, that nuts, seeds, corn and popcorn were out of my diet which my gastroenterologist confirmed. Although I am not a big nut and seed fan, I do like corn and popcorn.
After my diagnosis, I went online to learn as much as I could about this condition. After reviewing several websites, such as the Mayo Clinic and “WebMD”, I began to notice a trend in their recommendations about diet. The majority of them ended with similar statements. “Your doctor may recommend no nuts, seeds or corn, but there has been no evidence to suggest that these foods actually contribute to this condition.”
Have I stumbled upon one of these “our practices have not caught up with the science” findings or is there still legitimate rational for this restriction? Are we still preaching something that we no longer need to preach?
DEAR READER: Many gastroenterologists have changed their opinions about a diet for diverticulitis (infected diverticula). Your quote seems to sum up the latest recommendation. I am not aware of any recent studies about seeds (and the like) causing diverticulitis.
There is one way to help prevent diverticulitis and diverticula (intestinal out-pouches caused by weak spots and pressure): a high fiber diet. Diverticulitis is rarely present in areas of the world that regularly consume this type of diet. In fact, it was almost unheard of until the invention of steel-grind mills which remove most of the fiber from rice and wheat to make flour.
Diverticula do not usually cause problems and are most often found by accident during routine screening tests for colon cancer and other intestinal disorders. Diverticulitis, however, is generally diagnosed during an acute attack. Common symptoms include left lower abdominal pain, fever, nausea, constipation or diarrhea and abdominal tenderness. Less common symptoms are vomiting, rectal bleeding, frequent or painful/difficult urination, bloating and abdominal tenderness while wearing a belt or bending.
Treatment options vary. For mild to moderate attacks, home care is often recommended and includes a low-fiber or liquid diet, rest for the duration of the attack and oral antibiotics. Once the attack has subsided, fruits, vegetables and whole grains can be (slowly) introduced back into the diet. Severe cases or individuals who have recurrent infections or are at high risk of complications such as peritonitis (abdominal inflammation due to intestinal rupture), bleeding, intestinal blockage, abscess or fistula (abnormal passage between intestine and abdominal cavity, bladder or vagina), that should be treated in hospital with IV antibiotics and special diets. Some individuals with complications or frequent attacks may benefit from surgery to remove the diseased section of the colon and repair damage, such as fistulas.
It is important to see a doctor as soon as possible if you think you are having an attack of diverticulitis. It can mimic other disorders such as appendicitis. The sooner treatment is begun, the shorter the attack will be.
To give you related information, I am sending you a copy of my Health Report “Diverticular Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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