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Once you’ve reached your senior years, there’s a better-than-average chance you have diverticulosis, the development of small pockets, or diverticula, in the muscular layers of the colon (large intestine). Sounds serious, right? Not always. In fact, most of the time these pockets are harmless. But, about four out of 100 people with them develop diverticulitis, which is inflammation or infection of one or more diverticula.
If you have diverticulosis or a history of diverticulitis, diet is important to help promote good digestive health, and it might help you avoid painful repeat episodes of the disease. Essentially, a diverticulitis diet is a colon-friendly diet.
Understanding Diverticular Disease
Diverticula range from pea-sized to marble-sized and form when increased pressure from gas, waste, or straining due to constipation is applied to weak areas of the colon wall. Although they can develop in the stomach or anywhere in the intestines, most diverticula occur in the sigmoid, the lower left side of the colon.
Diverticulosis usually does not cause symptoms, but sometimes the small blood vessels next to the diverticula become exposed, resulting in bleeding. In other instances, one or more diverticula become blocked with waste, fostering a buildup of bacteria and leading to the inflammation and infection of diverticulitis. The disease causes painful cramps that resemble appendicitis; diverticulitis symptoms, however, usually occur on the lower left side of the abdomen instead of the right. Some patients with diverticulitis develop chills or fever.
Most diverticulitis patients have a relatively mild attack and mild infection that resolves relatively quickly. Patients with severe diverticulitis may require hospitalization and intravenous antibiotics. Less commonly, abscesses or a perforation of the colon can occur, requiring emergency surgery.
Diverticulitis Diet Strategies
For years, seeds, nuts, popcorn, and other hard-to-digest foods were considered taboo for a diverticulitis diet. The fear was that these foods would become lodged in the diverticula and cause inflammation and other complications.
However, in its 2015 guidelines for managing acute diverticulitis (the most common form of the disease), the American Gastroenterological Association (AGA) recommends against routinely advising patients with a history of diverticulitis to avoid eating seeds, nuts, and popcorn. Still, it’s best not to consume these foods during a bout of diverticulitis.
Diverticulitis Diet Recommendations
While your diverticula are inflamed or infected, your doctor will recommend you follow a low-fiber diverticulitis diet for a few days to allow your colon to rest.
At first on your diverticulitis diet, you might be limited to items such as water, pulp-free fruit juices, broth, gelatin, or tea or coffee (without cream). Then, as your symptoms begin to improve, you might move to lower-residue foods, such as white bread, white rice, or white pasta; milk, yogurt and other dairy products; poultry, eggs, or fish; or certain fruits or vegetables without seeds or skin. Your doctor and/or a nutrition specialist can guide you on the appropriate diverticulitis diet choices.
If you have diverticulosis and aren’t suffering acute diverticulitis, diet advice changes, and fiber becomes the focus. The AGA recommends that you get ample fiber from your diet or, if necessary, fiber supplements. A diet low in fiber can result in stools that are hard to pass and increased colonic pressure—the higher the pressure in the colon, the greater the risk of forming diverticula. Beans, peas, and lentils, as well as oats, and vegetables such as cauliflower, broccoli, green beans, and potatoes, are good sources of insoluble fiber, which helps move stool through the digestive tract.
The Institute of Medicine of the National Academies recommends consuming 38 grams of fiber a day for men up to age 50 and 30 grams a day for older men, while women up to age 50 and those age 51 and older should consume 25 and 21 grams of fiber a day, respectively. Unfortunately, most Americans eat only about 15 grams of fiber daily.
Still, the amount of fiber that promotes good digestive function varies from person to person. So, talk to your physician and/or a registered dietitian about the appropriate amount of fiber you need so that you produce normal, soft stools that pass easily. Plus, balance the pros of fiber consumption with the cons—namely, gas or bloating that you might experience from eating more fiber. To minimize these effects, try increasing your fiber intake gradually by five-gram increments over a few weeks.
Treat Your Colon with Care
Besides following a diverticulitis diet, you can take other steps to care for your colon and, potentially, reduce your risk of diverticular disease:
- Maintain a healthy weight. Research suggests that people who are overweight or obese face an increased risk of diverticulitis and diverticular bleeding. If you’re overweight or obese, work with your healthcare team to develop a diet and exercise plan that can help you lose weight.
- Stay physically active. Multiple studies have found that physical activity, especially more vigorous activity, can improve the function of the colon and help counter constipation, thus lowering pressure in the colon.
- Practice good bowel hygiene. Don’t put off going to the bathroom if you feel the urge. If you do, you can cause stool to back up in the colon and rectum, leading to constipation that increases colonic pressure.
Sources & Resources
For related reading, see these posts:
- Break the Diverticulitis Cycle
- 8 Diverticulitis Symptoms You Should Watch Out For
- Diverticulitis Definition, Treatments, and Prevention
Originally published in 2017, this post is regularly updated.