Diverticulitis Food Restrictions

Diverticulosis is a condition characterized by small, saclike out-pouchings, or diverticula, that protrude from your colon. Diverticula are presumed to result from eating a low-fiber diet over long periods of time, which increases the pressure inside your intestine and causes "ballooning" at points of weakness in the intestinal wall. Because diverticulosis occurs almost exclusively in developed countries, in the 1970s it was labeled "the disease of western civilization." Dietary restrictions are often recommended to help prevent the complications of diverticulosis, but the evidence to support such recommendations is not convincing.

Complications

Most diverticula do not cause problems. They are usually discovered incidentally during colonoscopies or barium enemas performed for other reasons. However, diverticula sometimes bleed or become inflamed, a condition known as diverticulitis. Diverticulitis can cause perforation of a diverticulum, which can then progress to abscess formation, generalized infection of the abdominal cavity, a condition known as peritonitis, or the formation of an open tract, called a fistula, between the colon and nearby structures.

Signs and Symptoms

Diverticulitis usually announces itself with pain, most often in the left lower part of your abdomen, and fever, according to "The Merck Manual of Diagnosis and Therapy." Life-threatening perforation and peritonitis can develop quickly in severe cases. If sufficient swelling occurs around the inflamed diverticulum, symptoms of bowel obstruction, such as nausea, vomiting and severe pain, can develop.

Dietary Restrictions

If you know you have diverticulosis, and particularly if you have had a previous bout of diverticulitis, your doctor may have already made some dietary recommendations. A 2005 article in "American Family Physician" summarizes the current belief that dietary restrictions have little impact on preventing diverticulitis. However, despite the lack of controlled studies to support such restrictions, physicians still advise their patients to avoid nuts, small seeds, popcorn, corn, strawberries, cauliflower and any number of foods that are presumed to get trapped in diverticula and trigger inflammation.

Preventing Diverticulitis

The addition of fiber to your diet may help to prevent diverticulitis by lessening the pressure within your colon and improving bowel activity. One 1998 review in "The Journal of Nutrition" demonstrated that a high-fiber diet, with or without supplemental fiber such as psyllium or methylcellulose, appears to lessen the likelihood of diverticulosis and its complications. Caffeine, alcohol and smoking do not appear to increase your risk for diverticulosis, but a lack of physical activity probably does.

Considerations

Even though dietary restrictions, in general, do not seem to reduce the risk for diverticulitis, you may find that there are certain foods that do cause problems for you. Maintaining a diary of such items is helpful. For example, if you discover that eating popcorn gives you a lot of gas, bloating, cramping and diarrhea, you should avoid it. If your diet does not already contain generous amounts of fiber, consider adding twice-daily doses of psyllium or methylcellulose to your routine. If you think you might have diverticulosis or diverticulitis, see your physician as soon as possible.