Dr. Karen Zaghiyan: The Colorectal Surgeon Behind the Food List

In the first week of 2024, Dr. Karen Zaghiyan posted a video counting off ten things she would never do as a colorectal surgeon. She would never use wet wipes; get a bidet instead. She would never book a colonic, because the way to “cleanse” a colon, she said, is a high-fiber diet. She would never sit on the toilet for more than five minutes scrolling, because sitting there pulls on the veins that become hemorrhoids. And if she ever had cancer, she would never trade mainstream treatment for alternative therapies. She has watched patients with curable cancers come back after that chance had passed, and she called it one of the most devastating things she deals with. “List has grown longer in 2024,” she captioned it. It has been played more than seven million times.

Zaghiyan is a medical doctor and a colorectal surgeon at Cedars-Sinai Medical Center in Los Angeles. She treats the last stretch of the digestive tract, the colon, rectum and anus, from hemorrhoids to cancer. Her practice site and her own social bios describe her as a board-certified colorectal surgeon. On TikTok, where more than 140,000 people follow her, her bio carries two plain disclaimers: “No Med Advice” and “Views my own.” Gastroenterologists such as Dr. Wendi LeBrett and Dr. Joseph Salhab have built big audiences explaining the gut. Zaghiyan does it as the surgeon, from the end that people find hardest to talk about.

The path: Thirty-hour calls, then Cedars

Her route there, per her practice site, ran through a biology degree from UCLA, magna cum laude; medical school at UC San Diego; general surgery residency and a colon and rectal surgery fellowship at Cedars-Sinai; then further training in minimally invasive colorectal surgery in Singapore. Her site lists her as an associate professor of surgery and director of the colorectal cancer tumor board at its Samuel Oschin Comprehensive Cancer Institute, and she helps run the hospital’s training program for future colorectal surgeons. This year she was among the authors of the long-term results, in Annals of Surgery, of a North American multicenter trial of transanal total mesorectal excision, an approach to low rectal cancer designed to help preserve the sphincter.

She is frank about what the training took. “Grit,” begins the caption on one 2024 post: nobody gets through five years of 30-hour in-house calls every fourth night on IQ alone, she wrote. As an attending she still takes, in her words, “a whole month of call at a time: twice a year!” And when people ask her for career advice, her answer is short: “Find something you are passionate about. Then go for it and be the best you can be in that field. Everything else falls into place.”

The specialty: Hemorrhoids, without the euphemisms

Her TikTok playlist for hemorrhoids and other anorectal problems runs to 72 posts, more than any other medical topic on her page. In one from August 2024, she takes on the question she says she is asked most: can hemorrhoids be gotten rid of “for good and forever”? Her answer starts with an anatomy lesson. Hemorrhoids are normal veins everyone is born with, she explains, and they help keep the anus closed and protect the muscles there; the trouble starts when they swell, like varicose veins, and bleed or bulge. So when she operates, she tries not to remove every last one, to avoid trading today’s problem for “a forever problem.” Treatment is “a team approach,” she says: she does her part, and diet and daily habits have to change too.

That conservative streak runs through her feed. In the ten-things video she said she would not have a hemorrhoidectomy without first trying less invasive treatments, and that anyone offered one at a first consultation should get a second opinion. In 2025 she was posting about the laser, which she called “my newest favorite treatment for hemorrhoids, fistulas, and Pilonidal disease!” She also has a line for anyone wiping witch hazel on every day: “Putting on your bum daily like it’s Windex and You’re Greek is not recommended,” she wrote. For the basics of what hemorrhoids are and what helps, see our explainer.

The food list: Five foods, and a cart with no deli meat

Search her name and one of the suggestions is “food list.” The list people mean lives on her TikTok, and it comes in versions. In November 2022 she posted “5 foods I limit as a colorectal surgeon!” It was a confession as much as a list: bacon, which she loves in a breakfast burrito; deli meats, including mortadella from Armenian markets; pepperoni, on her favorite pizza with onions and mushrooms; hot dogs, a taste of nights out in college; and a good steak. She did not swear them off. She said she tries to limit them because of the research linking cured and processed meats to bowel cancer.

Two years later, in November 2024, she sharpened it into five foods linked to a higher risk of colorectal cancer: red meat, processed meat, sugar-sweetened drinks, alcohol, and ultra-processed foods, the packaged products that, as she put it, do not exist in nature. She framed it around the rise of colorectal cancer in younger adults, which she said nobody can yet fully explain, though diet may play a part. On red meat: “We don’t know of a safe amount.” On processed meat: “the less you eat the better.” And she closed on the other half of the list, what to add rather than what to cut: more fruit, vegetables and whole grains, every day.

That add-more half is where she lives day to day. The recommended fiber intake is 25 to 35 grams a day, she wrote, “Best if consumed through food, not a supplement,” and to reach 30 she suggests berries, a salad with a whole avocado, a handful of almonds and an apple in the evening. New to fiber? Go slowly, she says, because gut bacteria do the work. “But slowly you can teach your gut to love fiber,” she wrote. She has posted her own grocery cart (“Did you notice no processed meats in that cart?”) and, from a summer 2024 trip, the fruit stands on every street corner, noting that fresh and dried fruit is “heavily consumed in Armenian culture.” It is her list, for her own kitchen, and she tells viewers to talk to their own doctors. For constipation, she points first to fiber and water; more in our guide to constipation.

The hard conversations: Surgery is not a failure

Her YouTube explainers, written in her voice, take on the moments patients dread. People with Crohn’s disease who need an operation often feel they have failed treatment; she reminds them it is a chronic inflammatory disease, and that sometimes medication alone cannot reverse scarring or narrowing. Patients panic at the word ileostomy, she writes, so she explains that some are temporary and that people with one “travel, exercise, swim, work, date, and return to very active lives.” People with diverticulitis start cutting out food after food for fear of another attack. For years they were told to avoid nuts, seeds and popcorn, she notes, “but the research doesn’t really support many of those old recommendations.”

Her hospital work keeps the same focus. On Sunday, September 27, she was one of a dozen clinicians and researchers listed as speakers at “Your Life, Your Hormones, Your IBD: Women’s Health at Every Stage,” an afternoon event Cedars-Sinai organized on its Los Angeles campus. The same week, her Instagram carried several posts made jointly with the Cedars-Sinai Inflammatory Bowel Disease Institute. Her link page also points to Z For A Cure, a team in the Crohn’s & Colitis Foundation’s Los Angeles Take Steps walk.

What the research actually measured: Behind the list

Her food list rests on research that is real but mostly observational. In 2015 the World Health Organization’s cancer agency, IARC, classified processed meat as carcinogenic to humans and red meat as probably carcinogenic, and its experts concluded that each 50-gram portion of processed meat eaten daily raises the risk of colorectal cancer by 18% (summarized in The Lancet Oncology). IARC stressed that for an individual this risk “remains small,” and WHO says the data did not allow a conclusion about whether a safe level exists. The sugary-drinks figure traces to a 2021 study in Gut of 95,464 women in the Nurses’ Health Study II: those who drank two or more servings a day had a little more than twice the risk of colorectal cancer before age 50 as those who had less than one a week. It counted 109 such cancers, in women only: an association, not proof of cause.

On her home turf the evidence is more direct. A 2006 meta-analysis of seven randomized trials with 378 patients found that fiber cut the risk of hemorrhoid symptoms persisting by 47% and the risk of bleeding by half. Another item on her ten-things list was choosing a colonoscopy over a stool test. A 2014 trial in the New England Journal of Medicine of nearly 10,000 people shows the trade-off: a stool DNA test caught 92.3% of cancers but only 42.4% of advanced precancerous lesions, the growths a colonoscopy can find and remove. These are findings about groups of people, not a personal plan; screening and diet decisions belong with your own doctor.

The disclosure map: Where her interests sit

Zaghiyan’s clinical work is also her business, and it is worth naming plainly. She sees patients at her Beverly Boulevard office, operates at Cedars-Sinai, and her videos often invite viewers to book a consultation. Her link page includes an Amazon storefront. In May 2024 she made a TikTok post marked #sponsored for the bidet brand Tushy, with a personal promo code. Her media page lists directory listings such as Super Doctors and Castle Connolly alongside her press and podcasts. Gut Health Times has no commercial relationship with her, her practice, Cedars-Sinai or any of these companies. This profile is educational, is not medical advice, and was prepared without input from Dr. Zaghiyan.