I am a fairly new lapband patient. I recently had a severe diverticulitis attack and was hospitalized 4 days. I have had previous attacks but never this bad and never hospitalized. I am on 2 strong antibiotics. In a few weeks will have an upper and lower scope to decide if I need bowel resection for the dangerous recurrent diverticulitis.
Right now I am afraid to eat solid food with any nuts, seeds, popcorn. There seems to be several different opinions online in articles about diverticulitis attacks and how to prevent them. Please advise me and other people concerned about this common condition because it is a scary and potentially deadly condition. I had a neighbor who died from peritonitis from a perforation of diverticulitis.
Dr. Larson’s Response:
I chose this question for my first “Ask the Doctor” because I am asked it all the time in my surgery practice both in the office and at the hospital. I don’t blame you for your frustration because it is very common for me to meet people just like you who have been given different advice by three different caregivers the same day in the same hospital. Perhaps the gastroenterologist advises no nuts and seeds while the nutritionist might recommend a “low residue” diet while the surgeon then suggests more fiber. What’s a person to do and who to trust?
For our readers’ benefit diverticulitis is an infection of the abdomen that starts in the colon (rarely it can start in another part of the intestinal tract but my answer to this question applies only to the much more common colonic diverticulitis) and ranges in severity from requiring a trip to the doctor’s office for antibiotics to a hospital stay for intravenous antibiotics to even surgery. As you pointed out in exceptional circumstances diverticulitis can be fatal.
Melanie’s weight loss surgery (Lap Band) is not related to her diverticulitis occurring but there is a small yet measurable increased risk of diverticulitis if you are overweight. Lack of exercise seems to also play a small role….maybe due to less vigorous bowel function. Chronic constipation is a risk factor. Diverticulitis is rare in parts of the world where fiber consumption is high. A high fiber diet containing beans, whole grains, fruits and vegetables is associated with a lower risk of developing diverticulitis. Fiber helps with constipation in many cases so you can see how it might help with preventing diverticulitis also.
Regarding popcorn, nuts , corn, and seeds. A study in the August 27, 2008 issue of the Journal of the American Medical Association showed that people who ate nuts and popcorn were actually less likely to develop diverticulitis. Corn had no effect in this study and seeds were not individually looked at. There are no academic studies showing that these foods cause diverticulitis. Because corn, all dry roasted or raw nuts, all seeds, and popcorn, so long as it’s not excessively buttered nor processed and artificially “enhanced” with hydrogenated oils, are all healthful foods they should NOT be avoided to prevent or treat diverticulitis.
While I cannot give medical advice specific to Melanie’s condition without examining her and reviewing her records it seems that the antibiotics, colonoscopy, and consideration for surgery (given multiple previous attacks) are all appropriate. While I am not a fan of the overuse of antibiotics confirmed active diverticulitis is a dangerous condition and should always be treated with antibiotics to reduce the risk of serious complications. There is no reasonable “all-natural” therapy for this condition once it has been confirmed….a CT scan is the most accurate test. Fortunately, the diet and lifestyle choices I’ve discussed can reduce the risk of developing this condition in the first place and reduce the risk of it re-occurring.
Andrew Larson, MD