High fiber diet plan for diverticulitis is one of the core treatment options for diverticulitis, a common medical problem that most adults over 50 face. Diverticulitis occurs when intestinal tissue pokes out of weak spots in the wall of the colon. The condition was once thought to be rare, but recent research shows that diverticulitis is a more common disease than once believed.
Diverticulosis, otherwise known as pockets or pouches of the colon, is very common. You can access a full description of this condition at Diverticulosis. The condition is almost certainly caused by a low fiber intake over a lifetime. This results in high pressures in the colon, which very, very slowly, over many years, cause ballooning of tiny weak points in the colon wall resulting in diverticuli. When these pockets become infected, diverticulitis occurs, a painful and, at times, serious condition. Rural Africans who consume 50 or more grams of fiber a day over a lifetime do not get diverticulosis. Yet, they do when they eat a Western diet with low fiber. Low fiber intake can result in small, thin and/or hard pellet stools, which usually means high pressure within the colon. Again, this high pressure is what causes these pockets to balloon out forming diverticuli.
These are dietary recommendations for people with diverticulosis. However, specific advice will depend on the stage of diverticulosis. Is it early diverticulosis? Is it advanced with fixed changes in the colon? Are there symptoms? Or is it acute diverticulitis where the colon is recovering from infection around these pockets?
What to Eat When You Have Diverticulitis
Since what affects someone’s diverticulitis can be, to an extent, personal, there is no scripted plan that is sure to help you. There are basics that can guide recommendations, but some of this may prove to be trial and error.
- High-fiber foods
- Apples, bananas, pears
- Broccoli, carrots, other root vegetables
- Brown rice
- Nuts and seeds
- Oats, rye, barley, whole grains
- Psyllium husks or fiber supplements
- Anti-inflammatory foods such as avocado and olive oil
- Beans, legumes
- Brussels sprouts, cabbage
- Fermented foods
- Fried foods
- Full-fat dairy
- Garlic, onions
- Red meat
- Trans fats
Nuts, seeds, and popcorn: In the past, people with diverticulosis were advised to avoid these because it was thought they would get caught in the diverticula and lead to diverticulitis. However, research now indicates these foods don’t specifically cause inflammation of the pouches.11 That’s good, as they are very good sources of fiber.
Spices: Ginger, turmeric, and garlic have anti-inflammatory properties, and ginger is a popular remedy for soothing stomach upsets. However, spices can be irritating to the lining of the gastrointestinal tract.12 You may want to avoid them after an acute episode of diverticulitis. Then start with small amounts and increase according to your comfort level.
Fruit: Fresh fruits like apples have the most fiber when eaten with the skin.13 Bananas are another good source of fruit fiber. They also have a lot of potassium and can be especially helpful if you’re recovering from a stomach upset. However, if you’re having symptoms of diverticulitis, look for lower-fiber options like applesauce.
Dairy: If you tolerate dairy, add low-fat milk, cheese, and yogurt to your diet. Even if you aren’t lactose intolerant, full-fat dairy may be harder to digest. When you’re experiencing a flare, especially if you have diarrhea, you may prefer to avoid dairy until you’re feeling better. Lower-lactose dairy products such as cottage cheese may be tolerable.
Grains: Whole grains are one of the best sources of dietary fiber. Choosing whole-grain bread, crackers, pasta, and brown rice can be a nutritious, tasty, and versatile way to add fiber to your diet. However, when you aren’t feeling well, stick to low-fiber foods such as refined white bread, white rice, and crackers until your symptoms improve.
Protein: Lean ground meat and eggs are a great protein source whether you’re having symptoms or you’re feeling well. You can also experiment with higher-fat sources of protein like nuts and nut butters.14 However, they might not be the best choice during a flare of symptoms.
Red meat: You may want to avoid unprocessed red meat, as a study has found it is the main dietary risk factor for developing diverticulitis.15
Vegetables: When symptom-free and eating a high-fiber diet, raw vegetables (especially root and cruciferous veggies) are nutritional powerhouses.14 However, when symptomatic, you may want to avoid them. For example, a baked sweet potato with the skin may be too hard to digest. Instead, peel and mash a white potato.
Beverages: Proper hydration helps prevent constipation and helps process the extra fiber you’re eating. Drink plenty of water and pay attention to whether or not other beverages—coffee, tea, wine—cause or worsen your symptoms. Some people avoid certain drinks when recovering from a flare, while others find they need to do so always.
Evolving Your Diverticulitis Diet
If a food is negatively affecting you, let your healthcare provider know. They can help you figure out the best way to reduce or cut it out while still getting adequate nutrition.
Talk to your healthcare provider about periodically trying to add new foods (or some you used to enjoy) into your diet. Having a compliant and nutritious meal plan is important for managing your diverticulitis, but so is having a plan you can stick with. With time, there may be an opportunity to add greater variety without impacting your symptoms.
When planning meals, you’ll need to think about how you feel as well as the reality of your day-to-day schedule. Some people who have digestive disorders feel better if they eat smaller portions more frequently rather than sitting down to three square meals a day.16
You may want to experiment with eating different amounts or types of food at different times of the day. You may also find certain combinations of food work well for you, while others do not.
As you’re planning meals and snacks, don’t forget to factor in fluids. You may want to keep a water bottle handy so you routinely sip throughout the day.
Many foods are easier to digest if you cook them and, in the case of produce, remove their skins. For example, when peeled and cooked, carrots, potatoes, and apples work well. Eggs can be poached instead of fried, and lean, ground meat that’s cooked until it’s tender can be another protein option.
While making changes to your diet may help manage diverticulitis, these changes can also affect other aspects of your health. If you have other medical conditions, such as diabetes, you may need to modify your diverticulitis diet.
For example, refined white bread is a staple of a low-fiber diet and can work well if you’re having a flare of inflammatory symptoms. However, if you have diabetes, you’ll need to be aware of the effect foods made with refined flour have on your blood sugar levels.17
Certain changes in your life may also require you to reevaluate your diet. If you are pregnant or nursing, for example, your nutritional needs will change. If you increase your level of physical activity or are recovering from illness, injury, or surgery, you may also have different dietary requirements.
Before you increase your intake of dietary fiber or start taking a fiber supplement, talk to your healthcare provider. If you have other health conditions or gastrointestinal disorders, such as irritable bowel syndrome (IBS), eating more fiber can make your symptoms worse.18
If you are managing another chronic health condition through diet, work with your healthcare team to make sure that your food choices help both conditions.
Even if you are otherwise healthy, you might experience gas, bloating, cramps, and other digestive symptoms when you make changes to your diet. The discomfort will usually get better as your body adjusts.
What Is a High-Fiber Diet?
According to the U.S. Department of Agriculture (USDA), most Americans do not meet their recommended daily allowance (RDA) for fiber. On a high-fiber diet, fiber consumption should meet or exceed the RDA for fiber—for adult women, 22 to 28 grams of fiber per day; for men, 28 to 34 grams per day.1
While fiber is a carbohydrate, it is not easily digestible. This means it can provide feelings of fullness after eating without spiking blood sugar or adding too many extra calories. Fibrous foods often need extra chewing, which can also increase satiety.
Increasing your intake of heart-healthy fiber as part of a balanced diet is associated with a number of benefits, such as a reduced risk of chronic disease and cancer and improved digestive health. A high-fiber diet may also aid in weight loss.
Food With High Fiber
Dried plums, known as prunes, are widely used as a natural remedy for constipation.
They contain high amounts of fiber, with nearly 3 grams of fiber per 1/4-cup (40-gram) serving. This is 12% of the American Heart Association’s Reference Daily Intake (RDI) of fiber.
The insoluble fiber in prunes, known as cellulose, increases the amount of water in the stool, which can add bulk. Meanwhile, the soluble fiber in prunes is fermented in the colon to produce short-chain fatty acids, which also can increase stool weight.
In addition, prunes contain sorbitol. This sugar alcohol is not absorbed well by the body, causing water to be pulled into the colon and leading to a laxative effect in a small number of people.
Finally, prunes also contain phenolic compounds that stimulate beneficial gut bacteria. This has been hypothesized to contribute to their laxative effect.
One older study in 40 people with chronic constipation found that eating 3.5 ounces (100 grams) of prunes per day significantly improved stool frequency and consistency compared with treatment with psyllium, a type of dietary fiber.
You can enjoy prunes on their own or in salads, cereals, oatmeal, baked goods, smoothies, and savory stews.
Prunes are high in fiber, sorbitol, and gut-healthy phenolic compounds, all of which can help treat constipation.
Apples are rich in fiber. In fact, one medium apple with the skin on (about 200 grams) contains 4.8 grams of fiber, which is 19% of the RDI.
Although most of that fiber is insoluble, apples also contain soluble fiber, which is mostly in the form of a dietary fiber called pectin.
In the gut, pectin is rapidly fermented by bacteria to form short-chain fatty acids, which can pull water into the colon, softening the stool and decreasing gut transit time.
One study in 80 people with constipation found that pectin accelerated stool movement through the intestines, improved symptoms of constipation, and increased the amount of beneficial bacteria in the gut.
Another older animal study found that rats fed a diet of apple fiber had increased stool frequency and weight, despite being given morphine, which causes constipation.
Apples are an easy way to boost the fiber content of your diet and alleviate constipation. You can eat them whole on their own or slice them up to add to salads or baked goods. Granny Smith apples have a particularly high fiber content.
Apples contain pectin, a type of soluble fiber that can soften the stool and promote its movement through the digestive tract.
Pears are another fruit rich in fiber, with about 5.5 grams of fiber in a medium-sized fruit (about 178 grams). That’s 22% of the RDI for fiber.
Alongside the fiber benefits, pears are particularly high in fructose and sorbitol compared with other fruits.
Fructose is a type of sugar that some people absorb poorly. This means that some of it ends up in the colon, where it pulls in water by osmosis, stimulating a bowel movement.
Pears also contain the sugar alcohol sorbitol. Like fructose, sorbitol is not well absorbed by the body and acts as a natural laxative by bringing water into the intestines.
You can include pears in your diet in a wide variety of ways. Eat them raw or cooked, with cheese, or include them in salads, savory dishes, and baked goods.
Pears are rich in fiber and contain natural laxatives, such as fructose and sorbitol.
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One kiwi (about 75 grams) contains about 2.3 grams of fiber, which is 9% of the RDI.
In one study, 19 healthy adults consumed a kiwi-derived supplement for 28 days. Researchers found doing so led to significant increases in the number of daily bowel movements, compared with a control group
Another study found that eating two kiwis daily for 2 weeks was associated with more bowel movements and looser stools in 11 healthy adults.
Furthermore, a 2010 study gave 54 people with irritable bowel syndrome two kiwis per day for 4 weeks. At the end of the study, participants reported increased frequencies of bowel movements and faster colonic transit times.
Kiwis can be eaten raw. Just peel them or cut them in half and scoop out the green flesh and seeds. They make a great addition to fruit salads and can be added to smoothies for a fiber boost.
Kiwis are a good source of fiber and contain actinidin, an enzyme that may improve gut motility and reduce constipation.
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Figs are a great way to boost your fiber intake and promote healthy bowel habits.
One medium raw fig (about 50 grams) contains 1.5 grams of fiber. Moreover, just half a cup (80 grams) of dried figs contains 7.9 grams of fiber, which is almost 32% of the RDI.
An older study in dogs investigated the effects of fig paste on constipation over a 3-week period. It found that fig paste increased stool weight and reduced intestinal transit time.
Another study in 40 people with constipation found that taking 10.6 ounces (300 grams) of fig paste per day for 16 weeks helped speed colonic transit, improve stool consistency, and alleviate stomach discomfort .
Figs are a delicious snack on their own and also pair well with both sweet and savory dishes. They can be eaten raw, cooked, or dried and go well with cheese and gamey meats, as well as on pizza, in baked goods, and in salads.
Figs can help increase your intake of fiber and contain ficin, an enzyme that may promote regularity.
6. Citrus fruits
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Citrus fruits like oranges, grapefruits, and mandarins are a refreshing snack and good source of fiber.
For example, one orange (about 154 grams) contains 3.7 grams of fiber, which is 15% of the RDI. Meanwhile, one grapefruit (about 308 grams) contains almost 5 grams of fiber, meeting 20% of your daily needs.
Go to High Fiber Diet for full details. The goal is to increase the daily fiber to 20, 30 or even 40 grams per day. You do not want to do this all at once, and, especially with excessive amounts of soluble fiber as this fiber is the one that, if taken to excess, promotes the bacterial production of harmless colon gas and flatus.
This fiber, also known as roughage or bulk, does not dissolve in water but paradoxically hangs onto water in the large bowel. This creates a large, soft and bulky stool. It promotes regularity and seems to be associated with a reduced chance of getting colon polyps and colon cancer, as we believe cancer inciting agents are swept through the bowel in a more rapid manner. In addition, it may promote weight loss and it can enhance diabetic control. Foods that are high in insoluble fiber are:
- whole wheat bread and baked goods
- wheat bran
- whole grain breads
- vegetables and fruits, especially the skins
- Brazil nuts
- brown rice
Fiber Content of Foods, provides detailed information on the insoluble fiber content of many foods.
This plant fiber does dissolve in water. In the colon, it provides food for the enormous number of bacteria that thrive there and, in so doing, provides many health benefits. Soluble fibers also promote regularity by increasing growth of the colon bacteria. Foods that are high in soluble fibers are:
- oats in any form – cereal, muffins, etc.
- apples, oranges, grapefruit, peaches, concord grapes
- prunes, pears, cranberries
- sesame seeds
- psyllium found in dietary supplements and cereals
Fiber Content of Foods, provides information on the soluble fiber content of many foods.
Nuts, Seeds and Popcorn
From time immemorial, physicians have been advising patients with diverticulosis to avoid these items. Didn’t it just make sense that these could get inside colon pockets, rattle around and injure the colon wall? It was just like dried seeds inside a gourd that you can hear rattling around when you shake it. I have never agreed with this. I have never heard a patient rattling after eating these things. Furthermore, all of these items become digested or totally sodden and soft by the time they reach the colon. Most important of all, they contain excellent amounts of fiber, which is exactly what the colon wants. So, I have always recommended nuts, seeds and popcorn for diverticulosis patients. Now, I have been supported in this recommendation by a 2,007 study where a large number of diverticulosis patients who took these foods were matched against those who did not. You guessed it. The ones eating nuts, seeds and popcorn had less diverticulosis problems than those who did not.
Prebiotics are the relatively newly discovered types of plant fiber that have been shown to promote beneficial changes in the colon. These are present in certain plant foods as well as in our prebiotic products. In diverticulosis, all the soluble fiber foods and supplements can be a healthy addition. However, if too much is taken, then excessive colon gas can occur. If it is trapped behind a narrowed diverticular colon, there may be cramps and bloating. The advice is to take these healthy fibers in small, but increasing amounts and see if symptoms develop.