All good suggestions. But once you have diverticulosis, you will always have
diverticulosis - the diverticuli don't go away unless you have that section
of the colon removed (sigmoid colectomy, which is the ultimate solution).
The focus then becomes a) prevent the existing diverticuli from becoming
obstructed and then infected, and  b) prevent more diverticuli from
forming - because the more you have, the more likely you are to get
divertulitis.

The concept of fiber in the diet revolves around decreasing segmentation
pressure in the sigmoid colon, which is the cause of diverticuli. More fiber
= less pressure = less tendency to develop diverticuli.

Preventing diverticulitis revolves around preventing obstruction in the
existing diverticuli. Fiber help, by the same mechanism above, but only to
an extent. Foods that aren't fully digested, such as nuts of any kind, can
get trapped in a diverticulum and initiate an infection.

Diverticulitis can be successfully treated if an antibiotic regimen is
started soon enough, usually Cipro and Flagyl (or similar). If the infection
progresses too far, antibiotic treatment may not abort the infection before
the infected diverticulum perforates. If that happens, in most cases the
body will wall off the infection quickly, but if it's not quick enough, an
abscess may form, or there might actually be leakage into the abdominal
cavity and cause intraabdominal sepsis. If the former occurs without
intraabdominal sepsis, the abscess can usually be drained by percutaneous
drainage with CT or ultrasound guidance and emergent operation avoided. If
it doesn't wall off and leaks into the abdominal cavity, open operation to
remove the infected segment is usually needed, and in that case a temporary
(3 month) colostomy may have to be done, with yet another operation
(laparoscopic if your surgeon is skilled) to get rid of the colostomy and
reconnect the colon.

Generally, if someone is getting 2-3 bouts of acute diverticultis per year,
a laparoscopic sigmoid colectomy is advised.

HMc

Yawn...or, Dave could eat what he always eats (skip the nuts) and add a
couple of teaspoons of MetaMucil each day. Same effect, relative to his
diverticulosis.

HMc