Low‐Residue Diet in Diverticular Disease: Putting an End to a Myth

Abstract

Residue refers to any indigestible food substance that remains in the intestinal tract and contributes to stool bulk. Historically, low-residue diets have been recommended for diverticulosis because of a concern that indigestible nuts, seeds, corn, and popcorn could enter, block, or irritate a diverticulum and result in diverticulitis and possibly increase the risk of perforation. To date, there is no evidence supporting such a practice. In contrast, dietary fiber supplementation has been advocated to prevent diverticula formation and recurrence of symptomatic diverticulosis, although this is based mostly on low-quality observational studies. This report focuses on the evidence that fiber intake may be beneficial in the prevention and recurrence of symptomatic and complicated diverticular disease and provides recommendations regarding fiber supplementation in individuals with diverticulosis.

British Dietetic Association systematic review and evidence‐based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update)

“…It does not matter whether linseeds are golden or brown, whole or ground. Individuals with co-existing diverticular disease often avoid whole seeds as they may irritate diverticulitis (79) ; however, there is no evidence to suggest that seeds, nuts, corn or popcorn induce diverticulosis (80) . Encourage noncaffeinated and non-alcoholic fluids when fibre-rich foods are consumed to enhance the beneficial effects of dietary fibre on transit time.…”

Low-Residue and Low-Fiber Diets in Gastrointestinal Disease Management

“…The impossibility of estimating the amount of residue produced by the digestion of various foods complicates a consensus definition for residue. In the literature, residue mostly refers to any indigestible food substance that remains in the intestinal tract and contributes to stool bulk (3,5). This means that the residue of digestion is primarily indigestible material (i.e., dietary fiber), microorganisms, and secretions and cells shed from the alimentary tract.…”

Presentation, distribution pattern, and management of diverticular disease in a Nigerian tertiary hospital

“…Colonic diverticular disease, one of the most common and costly gastrointestinal disorders among industrialized societies, is characterized by the formation of sac-like outpouchings or pockets within the colon that form when colonic mucosa and submucosa herniate through weakened areas in the muscle layer (pseudo-diverticula). [1][2][3] It occurs at the point of entry of the small arteries that supply the colon, the vasa recta, penetrate the circular muscle layer of the colonic wall. [4,5] These entry points of the vasa recta are areas of relative weakness through which the mucosa and sub mucosa can herniate when under increased intraluminal pressure.…”