Don’t Go Nuts Over Nuts.

In my practice, I spend a great deal of time dispelling the myth that seeds and nuts are the main cause of diverticulitis.  My patients are told this by concerned friends, they read it on the internet, or they are told this by other physicians.

Diverticulosis is the condition of having diverticula, small outpouchings of the wall of the large intestine at areas of relative weakness in the wall of this organ.  These “pockets” are thought to occur over time due outward pressure applied to the walls of the large intestine during contraction of the bowel.  Diverticulosis is a common disorder in the United States.  We estimate that approximately 70% of individuals will have diverticulosis by the time they reach the age of 80.  It is one of the most common findings I encounter on routine colonoscopy examination.

The most common complication of diverticulosis is diverticulitis affecting up to 25% of those with diverticulosis.  Diverticulitis is inflammation and/or infection of the diverticular “pockets.”  This is caused by stool lodging in the neck of the diverticulum.  The stool abrades the lining of the pocket, causing inflammation and infection.  There is no good data to support the theory that seeds and nuts ingested cause diverticulitis.

Eating a diet rich in fiber as well as taking daily fiber supplements has been shown to lower the risk of diverticulitis.  We believe that the “protective” benefit of fiber is from “bulking” the stool thereby preventing small pieces of stools from lodging in the diverticular pockets.

So don’t go nuts over nuts!  You should focus on a low fat, high fiber diet.  This has health benefits on multiple levels: decreased risk of diverticulitis, decreased risk of colorectal cancer, and decreased risk of cardiovascular complications (eg. Stroke, heart attack, etc.)

Richard Warneke, M.D, M.S.