Background
- Diverticulitis is an inflammatory condition of diverticula, which are little outpouchings from the colon (they can look like caves).
- Diverticula are very common with aging; it is estimated that 50% of people over the age of 60 have them, and the incidence goes up as we get older.
- Incidence of diverticulitis is increasing worldwide, and like other inflammatory diseases, correlates with an urban lifestyle.
Main Takeaways
- The key importance of this paper is that it is quite comprehensive, and clearly lays out how “traditional” prevention and management approaches can be misguided. It outlines newer, evidence-based recommendations. I outline some of the highlights here.
- The authors clearly call out claims that people should avoid nuts, popcorn, and seeds (I hear this one a lot, and it makes no sense). In fact, in a study of 47,000 men, eating MORE nuts and seeds was associated with LESS likelihood of developing diverticulitis. Eating a diet containing insoluble fiber, especially cellulose (from plants) was the most protective factor. The authors point out that diets that are good in general for the gut, such as eating lots of fruits and veg, being sure to get plenty of fiber, and avoiding ultra-processed foods, have been shown to be true specifically for diverticulitis as well.
- Antibiotics have been a mainstay of treatment for diverticulitis, but recent findings now suggest that diverticulitis is more of an ongoing inflammatory condition, rather than an acute “infection”. Thus, the benefits of antibiotics are questionable. In fact, as the paper describes, clinical trials have shown that there is no difference in outcomes between patients with diverticulitis treated with antibiotics, and those who were not. It is important to note that with studies were done with “uncomplicated” diverticulitis (which is most cases) and that more serious cases will require more aggressive treatment.