In this chapter we look at the emotive subject of 'diet' in diverticular disease. In changing the terminology to 'food management', this chapter explores the myths and mysteries of the types of food that can and cannot be eaten by a patient with diverticular disease and whether food management can help control it.
As has been discussed in earlier chapters, diverticular disease is a common disorder in the western world affecting between 30% and 50% of the population aged over 60 years (Manousos et al., 1967; Burkitt et al., 1985). Although as many as 6500 patients a year are admitted to hospital for treatment of diverticulitis (Kyle et al., 1967), there are many more attending hospital outpatient departments for investigation of diverticular disease, who will not need surgical intervention. Once diagnosis is confirmed and if surgery is not indicated, there appears to be little left for the doctor to offer the patient to help with the disease. Often doctors call diverticulitis the 'cinderella disease' because there is nothing specific to do for the patient who has an expectation of 'cure' once the investigations are completed. Invariably patients are told that they must follow a diet' high in fibre, which will help them. But will diet' or food management help patients with diverticulitis? In concentrating on general bowel health, Hill (1999) suggested that fibre therapy should be based on clinical evidence, with the emphasis on the 'prescription' of a specific subtype of dietary fibre for a specific disease. Yet lack of agreement on fundamental issues in the dietary fibre story make it a difficult task when health professionals are giving advice and the current dietary guidelines need to be translated into foods that people can eat in their normal day-to-day living.
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