What to eat with diverticulosis

Dear Dr. Donohue: I know you have written about diverticulosis before, but would you mind going over it again? I was hospitalized with it and had to have intravenous fluids. My brother-in-law says that wasn’t necessary. He has it, and it has never caused him any trouble. He says he’s careful about not eating nuts, seeds, popcorn and berries, and that’s all you have to do for it. I know I was in pain, and I know it wasn’t imagined. Can you clear up these issues for me? — W.F.

Answer: Your brother-in-law is right about diverticulosis. It seldom causes severe pain. Diverticulosis is the formation of diverticula — small protrusions on the outer colon wall. It’s a condition widespread in countries where refining flour is the rage. Refining gets rid of fiber, and a low-fiber diet is believed to be a major factor in the development of diverticulosis. Fiber keeps undigested food soft, moist and easily propelled through and out of the digestive tract. Without it, stool becomes hard and dry.

The colon must exert great force to pass it through. That force generates diverticula formation.

You had more than diverticulosis. You had diverticulitis — inflammation of the diverticula. Each diverticulum connects with the colon through a narrow neck. If that neck becomes obstructed, bacteria in the diverticulum multiply and cause it to swell and become most painful. Swollen diverticula break and form abscesses, which add to the pain. Most often, diverticulitis must be treated in the hospital.

At one time, people with diverticulosis were uniformly instructed to avoid nuts, seeds, popcorn, berries and similar foods in the belief that they would obstruct the neck of a diverticulum and bring on a bout of diverticulitis.

That position isn’t universally adopted anymore. However, if your personal doctor tells you to avoid those and similar foods, do so.

He or she knows far more about your particular condition than does someone at a word processor hundreds or thousands of miles away from you.