Diverticula are tiny bulging pouches that may form in the lining of the digestive system, usually in the lower part of the large intestine. This condition is known as diverticulosis and as it often causes no symptoms, many people are unaware of it. Sometimes, however, one or more of these pouches become either inflamed or infected. This painful infection is known as diverticulitis. Diverticulitis, also known as colonic diverticulitis, is a gastrointestinal condition.
Symptoms of the condition tend to include lower abdominal pain, which may develop suddenly or over a few days, nausea, and constipation or diarrhea. Fever and blood in the stool are less usual and more severe symptoms, which may suggest a complication.
Unfortunately, experts have yet to fully understand the potential causes of diverticulitis. However, some of the most common risk factors include arterial hypertension and immunosuppression, obesity, lack of exercise, smoking, the use of nonsteroidal anti-inflammatory drugs, and low levels of vitamin D. A diet low in fiber may also be a risk factor, but the evidence is inconclusive.
Severe cases of diverticulitis may require treatment with antibiotics and even hospitalization and surgery. However, mild cases can and tend to be treated with diet. The right kind of diet is key to soothe the inflammation and to control the condition.
Liquid diverticulitis diet for severe symptoms
In case you are experiencing severe symptoms, your doctor may advise a short fasting period in which you eat nothing by mouth for a little while and thus give your digestive system a chance to rest and restore. This period may last a few hours and up to one day.
Afterward, you can switch to a liquid diet, which is often the first stage after the short fasting period. The liquid diverticulitis diet allows you to only ingest clear liquids and it may last for a few days. Ingest small amounts of clear liquids until symptoms like diarrhea, constipation, nausea, or bleeding subside. The diet may include:
- Ice pops and ice chips
- Pure tea
- Fruit juices (without pulp)
- Pure coffee (without cream or sugar)
As soon as you can tolerate solid low-fiber foods, your doctor will recommend you to add them to your diet, as a clear liquid diet doesn’t provide enough nutrients and as such, isn’t sustainable.
Regular diverticulitis diet
Once you start feeling better and the symptoms subside, you can gradually start adding low-fiber foods and then ease into a regular diet. Start with soft foods, such as yogurt, cooked fruits, and vegetables.
Low-fiber foods include:
- Cooked vegetables without skin or seeds
- Cooked fruits without skin or seeds
- Low-fiber cereals
- Dairy products
- Refined white bread
- White rice
After a few days, your symptoms should subside. In case they don’t, make sure to call your doctor. As soon as the symptoms disappear completely, you can start introducing high-fiber foods to your diet and switch to your regular diet. To make sure this condition doesn’t repeat itself and that these kinds of attacks don’t occur again, you can try switching to a prevention diet high on fiber-rich foods.
Diverticulitis may include some very unpleasant symptoms, therefore you probably want to do your best to prevent a diverticulitis flare-up. To do so, make sure to switch to a high-quality diet high on lean protein and fiber, which promotes gut health and prevents constipation (which is the number one risk factor for flare-ups).
Stick to a high-fiber diet
Numerous studies have found that choosing a high-fiber diet reduces the risk of diverticulitis. Insoluble fiber adds bulk to the stool, softens it, and helps it pass more easily and more frequently through the digestive system. Adding high-fiber foods to the diet also reduces pressure in the colon, prevents constipation, and controls diverticular symptoms. Women younger than 51 should eat 25 grams of fiber daily and women older than 51 should get 21 grams daily. Men that are younger than 51 should ingest 38 grams of fiber daily and older men should ingest 30 grams. Starchy vegetables will help you prevent indigestion and fiber-rich fruits will boost immunity and reduce constipation. Make sure to add high-fiber foods to your diet gradually, as a sudden switch may result in bloating and gas.
Fiber-rich foods include:
- Whole grains
- Brown rice
- Fortified cereals
- Vegetables, such as leafy greens, spinach, squash, peas, potatoes, sweet potatoes, broccoli, cauliflower, cabbage, Brussel sprouts
- Fruits, such as apples, prunes, pears, oranges
However, a diet full of high-fiber foods is only recommended if you have diverticulosis (inactive symptoms). When the symptoms are active and you have diverticulitis, on the other hand, make sure to avoid high-fiber foods and thus allow your digestive system to heal and restore. During a diverticulitis flare-up, only stick to a liquid diet at first and then gradually add foods low in fiber.
Add lean protein
Opting for lean proteins, such as white fish, white-meat poultry, beans, peas, lentils, tofu, shrimp, egg whites, peanut butter, low-fat milk, low-fat cottage cheese, and plain greek yogurt, has several health benefits. It will keep you feeling full longer without blocking your digestion. Plus, it will help you lose weight and avoid one of the biggest risk factors – obesity.
Include healthy fats
Healthy fats are light on digestion and they offer a large variety of health benefits. Ingesting sufficient amounts of healthy fats will boost your hormone production, improve vitamin absorption, promote your heart health and brain function. Foods high in healthy fats include avocados, olive oil, fatty fish, nut butter, nuts, chia seeds, dark chocolate, coconut, coconut oil, yogurt, and cheese.
Drinking lots of water and other fluids is also vital for preventing constipation. Make sure to drink at least eight 8-ounce glasses of water a day. Sufficient amounts of water will soften the stool and prevent diverticulitis flare-ups.
Know which foods to avoid
While there are no particular foods that all diverticulitis patients must avoid, some foods have been shown to irritate the colon, cause discomfort, and even trigger diverticulitis flare-ups. Make sure to refrain from foods that you personally find hard to digest, as little bits may get stuck in one of your pouches.
Foods that you may need to avoid include:
- Seeds. Flax, chia, poppy, and sesame seeds may get stuck in the diverticula. Instead of bypassing these nutritious foods altogether, consider grinding them. Fruits with small seeds, such as berries, can also cause similar issues.
- Corn. It may cause stomach pain and inflammation in the digestive system due to high amounts of fiber and sugar.
- Raw vegetables. The fiber in raw vegetables is fully intact and thus harder to digest, which may cause pain. If you cook them first, your body will be able to digest the fiber way easier.
- Cruciferous vegetables. These kinds of vegetables are particularly high in fiber. As such the body may have trouble digesting them and they may cause bloating. In case you do eat them, make sure to cook them beforehand.
- Spicy foods. In some cases, spicy foods may cause inflammation. If you feel any kind of discomfort, or even diarrhea or vomiting, make sure to avoid the foods that may have caused it in the future.
- Dairy. As some studies suggest that a large number of people with diverticulitis are also lactose intolerant or sensitive, you should also consider cutting down on dairy products, especially if you notice bloating after drinking milk or eating dairy products.
- Fast food, processed food, and foods high in sugar and saturated fats. These kinds of foods may cause inflammation, acid reflux, and thus irritate the condition.
- Red meat, high-fat dairy products, and refined grain products. According to some studies, people who follow a diet rich in these foods are more at risk of developing diverticulitis than people who eat large amounts of vegetables, fruits, and whole grains instead.
- High FODMAP foods. Following a low FODMAP (a type of carbohydrate) diet has been shown to benefit people with IBS (irritable bowel syndrome) and it may also be beneficial for people with diverticulitis. According to a 2016 study, a low FODMAP diet prevents pressure in the colon, which could (at least in theory) help prevent or even reverse diverticulitis. High FODMAP foods include certain fruits (plums, apples, pears), beans, cabbage, Brussels sprouts, onions, garlic, fermented foods, and dairy.
- Alcohol. A study has shown that excessive alcohol consumption may increase the risk of diverticulitis by 2 to 3 times compared to the people who consume smaller amounts of alcohol.
As we have mentioned before, each patient with diverticulitis may find different foods harmful or irritating. Instead of avoiding every food on the list of foods mentioned above (as many of them, especially vegetables, seeds, fruits, are generally considered very healthy), experiment with them, eliminate one type of food from your diet at a time, avoid it for a week or two and notice how you feel. Learn which foods may make you feel bloated, constipated, or cause pain and discomfort, and make your own personal list of foods to avoid.
If you believe that you are unable to consume an adequate amount of fiber, consider taking a fiber supplement, such as psyllium (Metamucil) or methylcellulose (Citrucel). Make sure not to exceed the recommended daily intake. However, you can only take fiber supplements when your symptoms are inactive, and not during a diverticulitis flare-up.
To prevent constipation, you can also try some natural or over-the-counter stool softeners. Prunes, prune juice, and psyllium seeds are great natural laxatives. Some teas are also known for fighting constipation. Make sure to avoid products containing senna, as this strong natural laxative can be addictive and cause strain on the colon walls. If you choose over-the-counter or prescription drugs, make sure to consult the doctor and don’t use them for long periods of time.
Some studies also suggest that using probiotics may help prevent and even relieve symptoms of diverticulitis, however, more research is needed to confirm the claim.
Alter your lifestyle choices
Leading a healthy lifestyle, in general, is also key to controlling your diverticulitis. In addition to following a healthy diet, also make sure to get enough sleep and to destress as often as possible. Regular physical exercise also offers a host of benefits. It can strengthen your intestine muscles and massage your digestive system, which may stimulate regular bowel movements. It is also important to mention that if you feel the urge to move your bowels, make sure not to delay it. In addition, make sure to maintain healthy body weight, stop smoking, and get enough vitamin D with regular sun exposure.