Diverticular disease and diet

Dear Readers and Henny,

It’s great that you’re reaching out about appropriate diets for diverticular disease and getting relief! For those who may not be familiar, diverticular disease occurs when small pouches or sacs, called diverticula, develop in weak spots in the walls of the colon. Diverticular disease is categorized into two conditions: diverticulosis and diverticulitis. Diverticulosis is when a person develops these small sacs, but they’re often asymptomatic, with the occasional cramping, bloating, constipation, or diarrhea. Diverticulitis, on the other hand, occurs when the sacs become infected or inflamed, resulting in fever, chills, nausea or vomiting, constipation or diarrhea, constant pain in the lower abdomen, and bleeding. For both of these conditions, diet can be a means of prevention and symptom management. Nutrition research suggests that consuming a diet high in fiber, with adequate probiotics, and supplemented with medication, can improve symptoms for those with diverticular disease. That being said, research doesn't indicate that there are specific foods that need to be avoided if you're living with diverticular disease. It’s critical to note, however, that each person's body has different nutrition needs and responds differently. Therefore, there isn't a "one size fits all" diet for those with diverticular disease. 

For a long time, it was believed that those who developed diverticular disease did so because they ate a low fiber diet, but the research on whether or not this is the cause is currently mixed. In fact, recent studies reveal that neurotransmitter levels in the body, smoking, obesity, lack of physical activity, and even use of some pain relievers (specifically non-steroidal anti-inflammatory drugs) may be linked to diverticular disease as well.

For those who’ve been diagnosed with diverticular disease, a high-fiber diet (in addition to fiber supplements, certain medications, and probiotics) has been found to 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)

While increasing fiber intake, it’s good to do so slowly and drink lots of water to make sure your gastrointestinal tract can adapt to these changes. Additionally, foods from other food groups may continue to be eaten — some people may simply find that some foods irritate their condition more than others.

Because each person's dietary needs are different, it's best to talk with a health care provider or registered dietitian about individual concerns about how to properly fuel the body or prevent further weight loss while still eating a high fiber diet. The dietary recommendations for diverticular disease depend on whether the focus is to prevent attacks or manage the severity of pain experienced during an attack, but generally speaking, incorporating fiber is a good idea for both. People with diverticular disease are advised to avoid foods that seem to aggravate their condition — so keeping a food journal may help to pinpoint any culprits. However, if someone experiences more severe symptoms, dietary changes such as a liquid diet are utilized to give the bowels a break. 

In the meantime, you may want to check out the National Institute of Diabetes and Digestive and Kidney Diseases or the Nutrition & Physical Activity section of the Go Ask Alice! archives for more information.

Take care,