Diverticular disease and diet

Originally Published: May 1, 1998 - Last Updated / Reviewed On: October 31, 2014
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(1)

Dear Alice,

We need information on good diets for people with diverticular disease. Food recommendations, books to read, etc.

Thank You.

(2)

Dear Alice,

I have diverticulitis. What can I eat, and what should I not eat? Thank you.

Dear Readers,

Diverticular disease occurs when diverticula, small pouches or sacs, develop in weak spots found in the walls of the colon. Depending on the state of these sacs, two conditions may result: diverticulosis or diverticulitis. The condition is referred to as diverticulosis if the small sacs do not become inflamed or bleed. Many cases are asymptomatic, but some people may experience cramping, bloating, constipation and/or diarrhea. If these sacs become infected or inflamed, this will, in turn, lead to diverticulitis. Symptoms can include fever, chills, nausea or vomiting, constipation or diarrhea, constant pain the lower abdomen, and bleeding. In the case of both conditions, diet can be a means of prevention and symptom management.

The long-held belief was that developing diverticulosis was associated with a low-fiber diet. More recent studies have challenged this notion, revealing that neurotransmitter levels in the body, smoking, obesity, lack of exercise, and even use of some pain relievers (NSAIDS) may be linked to diverticular disease. In light of this, research suggests that for those who’ve been diagnosed with diverticulosis, a high-fiber diet (in addition to fiber supplements, certain medications, and probiotics) may help relieve symptoms by reducing pressure on the colon and prevent further complications. Foods high in fiber include:

  • Dried beans and peas
  • 100 percent whole grain breads and cereals
  • Fruits — particularly those with skin or edible seeds (e.g., apples, pears, raspberries)
  • Vegetables (e.g., leafy greens, squash, potatoes, broccoli)

There are a few things to remember when increasing fiber intake: Take it slow! Increasing your fiber intake slowly will ensure enough time for your gastrointestinal (GI) tract to adapt. Also, keep your water bottle handy; drinking lots of water keeps stools soft and easier to pass.

Though the cause for diverticular disease is currently under investigation, experts agree that the inflammation associated with diverticulitis is caused by bacteria or feces caught in diverticula. Dietary changes recommended for diverticulitis depend on whether the focus is on preventing attacks or managing the severity of pain experienced during an attack. Prevention includes incorporating a high-fiber diet to reduce the risk of attacks. Some health care professionals used to think that particles from nuts, seeds, and hulls (like popcorn) could get trapped in the diverticula and cause diverticulitis attacks. However, there is no scientific evidence to indicate that these foods actually cause inflammation, and they can even be part of a high-fiber diet. People with diverticular disease should avoid foods that seem to aggravate them individually — keeping a food journal may help to pinpoint any culprits.

However, if someone experiences an attack, dietary changes are utilized to give the bowels a break. If the pain is mild, antibiotics and a liquid diet for a period of time may suffice as treatment. After that time, low-fiber foods are then added back to the diet. If there is significant pain, a hospital visit may be in order, which may include avoiding consumption of regular food and drink for several days. During this time, nutrition and antibiotics are administered intravenously (through an IV).  

To learn more about diverticular disease, check out the related Q&As below and the National Digestive Diseases Information Clearinghouse website.

Alice

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