Foods to eat with diverticulitis: treatment and prevention

What you eat can play a role in both preventing diverticular disease and treating recurrence of diverticular disease. diverticulitis. Diverticular disease causes small bulges or sacs called diverticula to develop in the large intestine (colon). There may be no symptoms. When diverticula become infected or inflamed, the condition is called diverticulitis.

Recommended diets vary depending on whether you have diverticulosis (not flared up) or are flared up. For example, a high-fiber diet may help prevent diverticulitis, but a low-fiber diet is often recommended during flare-ups.

This article reviews the foods you should eat during a diverticulitis flare and what you should eat to prevent future flares.

Liquid diet for diverticulitis

If your diverticulitis flares up severely, your health care provider may recommend a liquid diet. You may want to start a clear liquid diet. As your symptoms improve, you can gradually transition to an all-liquid diet and then a low-fiber diet.

Liquid diets are not recommended in the long term, as they cannot provide all the nutrients your body needs.

in clear liquid foodyou can eat the following:

• Fresh water
• Clear juices that do not contain pulp (such as apple juice or cranberry juice)
• Gelatin without fruit parts
• Popsicles without fruit pieces (popsicles)
• tea
• water

a complete liquid diet Includes all of the above and below.

• filtered cream soup
• Fruit juice (including those containing fruit pulp)
• milk
• pudding and custard
• Ice cream and frozen yogurt without fruit pieces, candy, nuts, or other solids
• nutritional supplement drink

Low fiber diet during flare-ups

For mild cases of diverticulitis, your health care provider may recommend a low-fiber diet. A low-fiber diet limits the amount of fiber you consume. Depending on the severity of your flare-up, you’ll be consuming between 8 and 12 grams of fiber per day.

High-fiber foods to avoid include whole grains, nuts, seeds, popcorn, beans, and fruits and vegetables (especially those with seeds or skins).

Low fiber foods include:

• red meat fillet
• chicken, seafood
• egg
• Tofu
• low fat dairy products
• Bread, cereals, and grains made with refined grains
• potato without skin
• A soft cooked fruit with seeds and skin removed
• fruit juice without pulp
• Plain soup or strained cream soup

Foods to avoid with diverticulitis

Apart from avoiding high-fiber foods during flare-ups, there are other foods to avoid when reducing symptoms.

high FODMAP foods

FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are a group of carbohydrates that are not easily absorbed in the intestine. For some people, FODMAPs can cause symptoms such as upset stomach, abdominal pain, bloating, gas, constipation, and diarrhea.

The low FODMAP diet was developed to help people with irritable bowel syndrome (IBS). However, some experts suggest that it may help patients with diverticulitis by reducing or preventing high pressure in the colon.

FODMAPs are found in foods such as:

• vegetables: Onions, garlic, mushrooms, peas, asparagus, cauliflower, artichokes, Brussels sprouts
• dairy products:Milk, ice cream, yogurt, custard, pudding, unsweetened milk, whole soybean milk
• fruits: Apples, cherries, plums, pears, dried fruits, mangoes, peaches, watermelons
• grains: Wheat, rye and barley based breads, breakfast cereals, baked goods and snack products
• nuts and legumes: most legumes and legumes (beans, peas, lentils, chickpeas), cashews, pistachios
• sweetener: Honey, high-fructose corn syrup, sugar alcohols (e.g. xylitol, maltitol, sorbitol, mannitol)

sugar and fat

The Standard American Diet (SAD), or Western diet, is often low in fruits and vegetables and high in foods high in saturated fat, sodium, and sugar. This low-fiber diet and high fat, sugar, and salt content can increase your risk of diverticulitis.

A 2017 study that followed more than 46,000 men for more than 25 years showed that a standard Western dietary pattern was associated with an increased risk of developing diverticulitis. (Please note that when citing research or health organizations, sex or gender terms from those sources are used.)

Foods high in sugar and fat include:

• sugary drinks
• Fried food
• Butter, full-fat dairy products, and cheese
• processed meat
• fatty red meat cuts
• Dessert foods such as ice cream, cookies, pastries, candies, and chocolates

processed meat and red meat

Research shows that a diet high in red meat combined with a low-fiber diet may increase the risk of developing diverticulitis.

A 2020 review on diet and diverticulosis found that high red meat intake slightly increased the risk of acute (short-term) diverticulitis. A 2021 research review suggested that high red meat intake is associated with an increased risk of diverticulitis.

On the other hand, protein foods such as chicken and fish were not associated with diverticulitis. A high-fiber diet rich in vegetables, fruits, and whole grains may prevent diverticulitis.

When can I return to my normal diet after diverticulitis?

Liquid or low-fiber diets are not meant to be taken for long periods of time. Liquid diets are intended to allow the intestines to rest and recover. In general, it is recommended that you only eat a liquid or low-fiber diet until your diverticulitis symptoms improve.

You can then gradually introduce solid foods back into your diet while slowly increasing your fiber intake. It is important to do this over several days to weeks to avoid gastrointestinal (GI) upsets such as bloating and constipation.

Prevent recurrence with a high-fiber diet

Eating foods high in fiber and reducing your red meat intake may lower your risk of developing diverticulitis.

Foods rich in fiber include:

• fruit
• vegetables
• Whole grain bread, pasta, tortillas
• Whole grains (brown rice, quinoa, barley, teff, corn, buckwheat, spelt, rye, etc.)
• Oats and whole grain cereal
• beans and lentils
• nuts and seeds

Other dietary considerations

Other aspects of your diet to watch out for include hydration and alcohol intake.

hydration

Staying hydrated is beneficial whether you have diverticular disease or not. Drinking plenty of water helps prevent dehydration and supports overall gut health.

You get water from the foods you eat, especially those that have a high water content, such as most fruits and vegetables. Water is the best drink to stay hydrated. Avoid or limit sweetened beverages that contain sugar, such as regular soda, fruit drinks, sports drinks, energy drinks, and sweetened coffee and tea.

alcohol

Heavy alcohol consumption can increase the risk of diverticulitis.

In a 2020 research review, researchers found a small association between heavy alcohol consumption and diverticulosis. Another review study in 2021 found that heavy alcohol consumption may be associated with diverticular bleeding, but not with frequent diverticulitis or diverticular complications.

However, a 2017 meta-analysis study found no significant association between regular alcohol consumption and an increased risk of diverticulosis (bulging pouch formation) or diverticular bleeding.

In general, it is best to avoid alcohol during diverticulitis flare-ups. If you drink alcohol when inflammation is not occurring, do so in moderation.

supplement

Your health care provider may recommend probiotics (supplements of good gut bacteria) to help treat chronic symptoms of diverticular disease. However, there is not enough research to draw conclusions about whether probiotics can help manage diverticular disease.

One study found that taking probiotics did not reduce diverticulitis flare-ups, but patients reported less pain, bloating, and fever.

Several other herbs and nutritional supplements, especially those with anti-inflammatory properties, have been suggested for diverticular disease. These include vitamin D, Flaxseed, garlic, ginger, green tea, marshmallow root, licorice, and turmeric. However, there is not much, if any, research done on these supplements in relation to diverticular disease.

Always consult your health care provider before using probiotics or other dietary supplements.

Create a long-term dietary plan with your health care provider

A diet high in fiber and low in red meat may lower the risk of diverticulitis. If you aren’t currently consuming much fiber, slowly increase your intake over several days or weeks. Be sure to drink plenty of water to avoid constipation and other digestive disorders.

Your health care provider may recommend an anti-inflammatory diet.

A 2020 study followed more than 46,000 men over 28 years and evaluated their diet and risk of diverticulitis. Researchers found that a reduced risk of diverticulitis was associated with an anti-inflammatory diet that was high in leafy green vegetables, dark yellow vegetables, coffee, and black tea, and reduced intake of red meat, processed meat, refined grains, and fruit. It was discovered that it may be related to sugary drinks.

Work with your health care provider or registered dietitian to create a long-term diverticular disease eating plan that fits your lifestyle.

summary

During diverticulitis flare-ups, it may be beneficial to continue on a liquid or low-fiber diet until symptoms improve. During a diverticulitis flare-up, it may be helpful to avoid high FODMAP foods, alcohol, processed and red meat, and foods high in fat and sugar.

During remission (no flare-ups), it is recommended to include foods high in fiber in your diet and limit your intake of red meat. Staying hydrated and following an anti-inflammatory diet may help prevent flare-ups.

Probiotics and other herbal and nutritional supplements may be recommended, but further research is needed to determine their effectiveness against diverticular disease. Always consult your health care provider before trying probiotics or supplements.