Expert Opinion: Diverticulosis

Dr. Moshe Shike is an attending physician at Memorial Sloan-Kettering Cancer Center and a professor of medicine at Cornell University Medical College. He is the director of the Cancer Prevention and Wellness Program at MSKCC. A gastroenterologist, Dr. Shike conducts research on nutrition in cancer, and has been examining the role of diet and specific dietary factors on various stages of cancer development. Discovery Health interviewed Dr. Shike about gastrointestinal diseases and the role nutrition plays in causing and treating them.

Q: Dr. Shike, what is diverticulosis?

A: Diverticulosis is a very common problem. It occurs when the wall of the colon has little pouches that protrude, creating little pockets or inlets along it. Diverticulosis makes the colon look much like a map of the coast of Norway with all the fiords. It is usually associated with constipation and vague discomfort.

In extremely rare cases, diverticulosis causes what is known as diverticulitis. This condition is very rare. When diverticulitis happens, there is a severe inflammation and sometimes a micro-perforation in the wall of the colon and an abscess. This disorder has to be treated by a physician and fairly quickly, because if it is allowed to go [undetected], it can cause major infection inside the abdomen. But the overwhelming majority of people with diverticulosis experience only problems like slight discomfort, constipation and some excess gas in the colon.

The best way that we know of to treat such symptoms is to increase fiber in the diet. So we suggest that patients with diverticulosis consume adequate amounts of fiber, 25 to 35 grams of fiber a day.

This disorder is in no way associated with cancer of the colon. Some people think that having diverticulosis may increase their chances of getting colon cancer, but it does not. Now, of course a lot of people who develop colon cancer have diverticulosis and vice versa, but diverticulosis itself does not predispose a person to colon cancer.

Q: At what age does diverticulosis typically occur?

A: Diverticulosis starts in middle age, and as people age it becomes more common. Usually with advancing age, we see it spreading throughout the colon. In most people, it is confined to the area toward the end of the colon. But in some people we see these little pouches throughout the colon.

Q: Should people with diverticulosis avoid things like seeds and corn on the cob that can get stuck in the pockets?

A: This is a commonly held belief. It is amazing how many people think that this is the case. But there is no evidence whatsoever that avoiding seeds or corn will improve this disorder, or that eating these things will cause any problems. So we don't suggest this as a part of a dietary restriction. We see a lot of people whose diet is heavily restricted because of this belief, and it's not justified, as there is no evidence that seeds or corn will aggravate their problem.