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Diverticulitis is the inflammation of small pouches or pockets called diverticula that form along your digestive tract, especially in the large intestine.
If you have these pouches, it’s called diverticulosis.
While these pouches are generally harmless, they can become infected or inflamed, resulting in diverticulitis.
Diet plays an important role in both the prevention and treatment of diverticulitis.
This article explains what to eat and avoid with diverticulitis and diverticulosis and provides a sample diverticulitis diet menu.
Causes and risk factors
Diverticulosis is one of the most common digestive diseases worldwide, especially in America, where 50% of Americans age 60 years and older have the condition (1).
Diverticulitis is the most common complication of diverticulosis, occurring in 10–25% of people with diverticulosis (1).
Several risk factors can contribute to the development of diverticulitis.
These factors include (1):
- increasing age
- overweight and obesity
- low fiber intake
- high red meat intake
- physical inactivity
Genetic factors and the use of certain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) can also increase the risk of diverticulitis (2).
Diverticulitis is the inflammation of the diverticula located along your GI tract.
These diverticula can become inflamed or infected if they become blocked with stool or partially digested food, which can cause the build-up of bacteria (3).
This inflammation can cause severe left lower stomach pain, the most common symptom of diverticulitis.
In Asian people, however, the pain is more often located on the right side (4).
If this pain is severe enough and you develop complications, you may require hospitalization.
Other symptoms of diverticulitis include (4):
- low-grade fever
You may also notice blood in your stools, but the stomach pain associated with diverticulitis does not usually occur with the bleeding.
Diagnosis and treatment
To diagnose diverticulitis, your doctor will likely review your health history and perform a physical examination to check your stomach for tenderness.
Your doctor may also perform additional tests to rule out other conditions that present similar signs and symptoms.
- blood tests to check for signs of inflammation
- abdominal CT scan or ultrasound to view your GI tract
- urine test to check for infections
- pregnancy test to rule out pregnancy
- stool sample to check for infections
- a colonoscopy to view your colon
If you have diverticulitis, these tests can help your doctor determine whether there are complications that require hospitalization for immediate treatment.
In either case, diet is an important component of diverticulitis treatment and can also help reduce the risk of future episodes.
If you’re experiencing diverticulitis with complications, your doctor may restrict you from consuming food or beverages by mouth (NPO).
This provides your bowels with rest until you’re medically stable.
If you have no complications, your doctor will likely start you on clear liquids for hydration and then advance your diet to a low-fiber diet until you start to feel better.
A low-fiber diet can reduce the frequency and volume of your stools, helping to reduce inflammation of your large intestine so that it can heal.
Foods to eat and avoid with diverticulitis
Consume a low-fiber diet — less than 10 grams per day — with diverticulitis until you feel better, which may take two to three days (5).
Additionally, also eat enough protein to promote intestinal healing.
Foods to avoid
Limit high-fiber and high-fat foods that can slow digestion.
Examples of foods to avoid with diverticulitis include:
- Grains: cereals, popcorn, seeds, nuts, brown rice, and whole-grain bread, pasta, and tortillas
- Protein: fried meat and processed meats, such as bologna, salami, sausage, bacon, and hot dogs
- Dairy: whole milk, cream, sour cream, and yogurt with added fruit, nuts, and granola
- Vegetables: raw or undercooked vegetables, including beets, broccoli, corn, cucumbers, peas, potato skins, spinach, and tomatoes
- Fruits: raw or dried fruit, canned fruit with mandarin oranges or pineapple, prune juice, and fruit skin
Foods to eat
Consume low-fiber foods that are easy to digest.
These foods include:
- Grains: cream of wheat, white rice, enriched white bread, crackers, pasta, white flour, corn tortillas
- Protein: fish, pork, chicken, eggs, tofu
- Dairy: low-fat milk, cheddar or parmesan cheese, cottage cheese, and yogurt without nuts, fruit, or granola
- Vegetables: cooked carrots or green beans, potatoes without skin, strained vegetable juice
- Fruits: fruit juice, canned peaches, pears, applesauce
One-day sample diverticulitis diet menu
Here is a one-day sample diverticulitis diet menu that is low in fiber and provides protein with each meal.
- 1/2 cup (89 grams) cream of wheat (0.5 grams of fiber)
- one slice of white toast with margarine (1 gram of fiber)
- three scrambled eggs
- two slices of white bread with butter (2 grams of fiber)
- 4 ounces (113 grams) of tuna
- 1 cup (240 grams) of chicken noodle soup (1 gram of fiber)
- 1 cup (226 grams) of low-fat cottage cheese
- 4 ounces (113 grams) of chicken breast
- 1 cup (174 grams) of white rice (0.5 grams of fiber)
- 1/2 cup (73 grams) of cooked green beans (2 grams of fiber)
How to reduce future diverticulitis flares
It’s estimated that 20–50% of people will develop recurrent diverticulitis episodes (2).
Fortunately, with diet and exercise, you can reduce this risk or lessen the complications that may result from future diverticulitis episodes.
High-fiber diet for diverticulosis
While a low-fiber diet can help during recovery from diverticulitis, eating a high-fiber diet after recovery can help prevent future episodes (6).
Research also suggests that a high-fiber diet can reduce the risk of hospitalization due to diverticulitis (7).
The best sources of fiber include:
- whole grains
- nuts, seeds, and legumes
Historically it was thought that nuts, seeds, and popcorn should be avoided because they may become lodged in the diverticula and lead to diverticulitis.
However, eating these items has not been associated with an increased risk of diverticulitis, and you should instead eat them for their fiber content (8).
For instance, an observational study of more than 50,000 women found that a higher intake of fiber from fruits and whole grains was associated with a reduced risk of diverticulitis (9).
Another observational study involving more than 46,000 men found that a diet high in fiber was associated with a decreased risk of diverticulitis (10).
Conversely, the same study found that the Western pattern diet — high in red meat, refined grains, and high-fat dairy products — was associated with an increased risk of diverticulitis.
A diet high in fiber can help reduce the risk of diverticulitis because it increases stool bulk and decreases pressure on your large intestine.
Fiber also stimulates the growth of good bacteria in your gut, which reduces inflammation and promotes intestinal health (11).
Consume 25–35 grams of fiber per day and drink plenty of fluids.
Slowly increase the amount of fiber you eat to avoid stomach discomfort and constipation.
Like a high-fiber diet, exercise has also been associated with a reduced risk of diverticulitis or hospitalization due to the condition.
For example, an observational study of more than 47,000 men found that those who engaged in vigorous physical activity were less likely to experience diverticulitis and bleeding than those who engaged in moderately intense physical activity (12).
Based on this study, the American Gastroenterological Association Institute guidelines recommend regular vigorous physical activity to reduce the risk of diverticulitis (13).
The Physical Activity Guidelines for Americans recommend 75–150 minutes per week of vigorous-intensity exercise (14).
Here are some examples of vigorous-intensity exercise:
- basketball game
- soccer game
Vigorous exercise may decrease the risk of diverticulitis due to its positive effects on the gastrointestinal tract and by reducing inflammation.
The bottom line
Diverticulitis is the inflammation of diverticula, which are small pouches that can form along your GI tract.
If you have diverticulitis but no complications, your doctor will likely recommend a clear liquid diet for hydration and then advance your diet to a low-fiber diet until you start to feel better.
After you recover from diverticulitis, consume a high-fiber diet and engage in vigorous exercise to reduce the risk of future episodes or complications from the condition.