Diverticular Disease: The Nuts-and-Seeds Rule Was Wrong, and Not Every Flare Needs Antibiotics

Summary

Two pieces of long-standing diverticular advice have quietly reversed: the decades-old ban on nuts, seeds and popcorn was never evidenced and a large prospective cohort found no harm (if anything a protective trend), and antibiotics are no longer mandatory for CT-confirmed acute UNCOMPLICATED diverticulitis (two randomised trials show observation is non-inferior, and the guidelines now say use them selectively, not automatically) — but neither reversal touches the two hard rules underneath: complicated diverticulitis (abscess, perforation, obstruction) still needs antibiotics and urgent assess