What should i eat with diverticulitis? Diverticulitis can be an unpleasant and even painful condition. So, you’re probably wondering what you should eat when you have diverticulitis. The good news is there’s no shortage of delicious foods that will help your body heal itself. And there are a few types of meals that should be avoided since they will make your condition worse. We’ll cover everything you need to know about food and diverticulitis in this article below.
Diverticulitis diet
Definition
A diverticulitis diet is something your doctor might recommend as part of a short-term treatment plan for acute diverticulitis.
Diverticula are small, bulging pouches that can form in the lining of the digestive system. They’re found most often in the lower part of the large intestine (colon). This condition is called diverticulosis.
In some cases, one or more of the pouches become inflamed or infected. This is known as diverticulitis.
Mild cases of diverticulitis are usually treated with antibiotics and a low-fiber diet, or treatment may start with a period of rest where you eat nothing by mouth, then start with clear liquids and then move to a low-fiber diet until your condition improves. More-severe cases typically require hospitalization.
Purpose
Nutrition therapy for diverticulitis is a temporary measure to give your digestive system a chance to rest. Eat small amounts until bleeding and diarrhea subside.
Diet details
Your diet starts with only clear liquids for a few days. Examples of items allowed on a clear liquid diet include:
- Broth
- Fruit juices without pulp, such as apple juice
- Ice chips
- Ice pops without bits of fruit or fruit pulp
- Gelatin
- Water
- Tea or coffee without cream
As you start feeling better, your doctor will recommend that you slowly add low-fiber foods. Examples of low-fiber foods include:
- Canned or cooked fruits without skin or seeds
- Canned or cooked vegetables such as green beans, carrots and potatoes (without the skin)
- Eggs, fish and poultry
- Refined white bread
- Fruit and vegetable juice with no pulp
- Low-fiber cereals
- Milk, yogurt and cheese
- White rice, pasta and noodles
Can diet help?
Diverticulitis is a condition where small pouches in the intestine called diverticula become inflamed or infected. Symptoms of diverticulitis can include abdominal pain, nausea and vomiting, fever, constipation, and diarrhea.
If a person has these pouches, but they are not inflamed or infected, the person has diverticulosis and will likely have no symptoms. According to current estimates, fewer than 5% of people with diverticulosis will develop diverticulitis.
A 2018 review suggested that risk factors for developing diverticulitis include aging, having increased fat around the abdomen, an inactive lifestyle, and difficulty eating a balanced diet.
The review concluded that there is not enough quality research to identify which diets are beneficial for an acute attack of diverticulitis. But they did suggest that following a high fiber diet after recovery from acute diverticulitis might reduce the risk of another episode.
Serious complications of diverticulitis may include:
- an abscess or perforation in the colon
- peritonitis, which is inflammation or infection in the abdominal lining
- a fistula, which is an uncharacteristic tunnel linking two organs or an organ and the outside of the body
- a blockage of the movement of food or stool through the intestines
Keep reading for more information about which foods to eat and avoid with diverticulitis.
Foods to eat
In one 2017 study on men, researchers suggested that a diet high in fruits, vegetables, and whole grains has an association with a decreased risk of diverticulitis.
A 2021 review linked a diet high in fiber with a lower risk of diverticulitis or hospitalization from diverticular disease. The review noted that fiber from fruits and cereal had a protective effect and diverticular disease, but vegetable fiber did not. It also stated that red meat consumption and a typical Western diet link to a higher risk of diverticulitis.
Fiber-rich foods
According to a 2019 study, for people experiencing acute, uncomplicated diverticulitis flares, doctors typically recommend a clear liquid diet followed by a low fiber diet until symptoms ease. More complicated cases of diverticulitis may require different treatments, such as an NPO or “nothing by mouth” order.
The Dietary Guidelines for Americans 2020–2025 recommend a dietary fiber intake of 14 grams (g) per 1,000 calories. A high fiber diet is one in which a person exceeds the dietary reference intake for fiber.
High fiber foods include:
- high fiber ready-to-eat bran cereal
- beans and pulses, including navy beans, chickpeas, split peas, and lentils
- fruits, including pears, avocados, apples, and prunes
- vegetables, including artichokes, broccoli, green peas, potatoes, squash, and parsnips
- grains, including bulgur, quinoa, barley, and whole wheat
If any foods aggravate symptoms, a person should speak with their doctor. The University of California, San Francisco noted that some doctors might suggest a person take a fiber supplement, such as methylcellulose (Citrucel) or psyllium (Metamucil).
Probiotics
Probiotics are beneficial bacteria that help the gut stay healthy. A 2018 review that included 13 studies noted that some findings suggest that certain probiotic strains may be effective in the treatment of diverticular disease.
But a 2021 systematic review of studies indicated that studies promoting probiotic benefits for diverticulitis are not sufficient to draw any meaningful conclusions. In other words, though probiotics may not hurt a person, they also may not provide any real benefit either. Currently, it is not clear which probiotic strains are most effective, or what dose and treatment time is most appropriate for people with diverticular disease.
People interested in probiotics can take them as a supplement, but they also occur naturally in some foods. These foods include natural yogurt and fermented foods such as:
- sauerkraut
- kefir
- tempeh
- miso
- kimchi
People who have been taking antibiotics might consider adding these foods to their diet to help repopulate their gut with beneficial bacteria.
A 2019 review of the health benefits of fermented foods suggested that the potential probiotic effects can support a healthy digestive system and may help symptoms of irritable bowel syndrome (IBS). But there is insufficient evidence to determine their impact.
Foods to avoid
A typical Western diet is high in red meat and refined grains and often includes lower fiber content. A 2017 study associated this type of diet with an increased risk of diverticulitis.
The UCSF noted that it is safe for people living with diverticulitis to eat nuts, popcorn, and seeds, including pumpkin and sesame seeds.
Experts also say that it is OK to eat the seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries. In the past, doctors may have advised people to remove these foods from their diets.
But each person is different, and some may find that particular foods worsen their symptoms.
Anyone who notices that a certain food causes pain or a change in symptoms may wish to eliminate that food and talk with their doctor or healthcare professional.
High FODMAP foods
FODMAP is an abbreviation for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are types of carbohydrates that can cause digestive symptoms, such as bloating, gas, and diarrhea in some people.
In Dietary Patterns and Whole Plant Food in Aging and Disease, the author commented that a low intake of FODMAP foods might help to lower the risk and alleviate symptoms of diverticular disease.
A 2016 hypothesis suggested that a high fiber diet, when combined with FODMAP foods, may cause excess gas that could contribute to diverticulitis symptoms.
Some high FODMAP foods include:
- onions, mushrooms, cauliflower, and garlic
- apples, apricots, dried fruits, pears, peaches
- dairy foods, including milks, yogurts, and cheeses
- legumes and pulses
- bread and cereals
- sugars and sweeteners
As some of these foods also contain beneficial fiber, a person should discuss their food choices and elimination with a healthcare professional before making drastic changes.
Each person will have different dietary needs and sensitivities, so doctors recommend individualized professional guidance.
Red meat
Research has linked higher intakes of red meat and processed meat with diverticulitis.
One 2017 study found that if people stick to certain lifestyle recommendations, it might be possible to prevent 50% of diverticulitis cases.
Recommendations from the study included consuming no more than 51 grams (g) of red meat a day, eating about 23 g of dietary fiber daily, doing at least 2 hours of vigorous exercise each week, maintaining a moderate weight, and never smoking.
Another study published in the journal Gut looked at biological males in the U.S. The study found that higher intakes of red meat, particularly unprocessed red meat, were associated with an increased risk of diverticulitis. The authors suggest that substituting red meat with poultry or fish may reduce risk.
How to follow a diverticulitis diet
“On the flip side, when you have diverticulitis, the polyps are upset, inflamed and maybe even infected. We want to reduce traffic in your GI tract so that nothing else irritates them,” says Taylor. “Decreasing the fiber in your diet helps with that.”
During a diverticulitis flare-up, your doctor may recommend rest, antibiotics and either a clear liquid or low-fiber diet.
Clear liquid diet for diverticulitis
If a diverticulitis flare-up is severe or requires surgery, your doctor may recommend a clear liquid diet. “After a day or two, you progress from clear liquids to a low-fiber diet,” says Taylor. “Even if your pain does not subside, you still move toward regular food. You can’t be on a liquid diet long-term because you can become malnourished.”
On a clear liquid diet, you can eat:
- Clear broths (not soup).
- Clear, pulp-free juices (such as apple and cranberry juice).
- Jell-O.
- Popsicles.
- Water.
Low-fiber diet for diverticulitis
For milder cases of diverticulitis, eat a low-fiber, or GI soft, diet. A low-fiber diet limits fiber intake to between 8 and 12 grams of fiber, depending on the severity of the flare-up.
Good low-fiber food options include:
- Grains: Lovers of white pasta and white bread, rejoice! Those are good low-fiber options, along with white rice and white crackers.
- Low-fiber starches: Get your peeler out. Potatoes without skin can be on the menu. Mash, roast or bake them. Certain low-fiber cereals also get a thumbs-up, including corn flakes and puffed rice cereal.
- Proteins: Choose eggs and egg whites, tofu, and meat or seafood. “It should be tender, so shredded chicken, lean ground beef and soft baked fish work best.”
- Fruits: Use caution since fruits have lots of fiber. Good options include canned fruits such as peaches or pears, applesauce, ripe bananas, and soft, ripe cantaloupe and honeydew. “It’s not a lot of fiber because you’re not eating the skin. The skins are the source of insoluble fiber, which can irritate inflamed polyps.”
- Dairy: “Cottage cheese and Greek yogurt are real winners if you’re recovering from a flare-up: They’re high in protein, calcium and other nutrients and don’t have any fiber. They’re also soft, moist and easier to get down if you’re not feeling well,” says Taylor. You can also have milk and cheese.
Foods to avoid with diverticulitis include high-fiber options such as:
- Whole grains.
- Fruits and vegetables with the skin and seeds.
- Nuts and seeds.
- Beans.
- Popcorn.
Follow the low-fiber diet until diverticulitis symptoms subside. “Usually they start to improve after several days of being on antibiotics,” Taylor says.
If they do, your doctor will have you gradually increase your fiber intake over several days to weeks to avoid constipation and bloating. “The goal is getting back to a high-fiber diet to decrease your risk for future bouts of diverticulitis,” Taylor adds. “But if you’re not feeling better within a few days, talk to your doctor.”
Top Foods to Eat for Preventing Diverticulitis
Fiber is your friend when it comes to good digestive health. It promotes good bacteria, keeps the digestive track clean, and helps bulk the stool so it’s easier to pass.
If you’re looking to ward off or manage diverticulitis, here are some of the best high-fiber foods to eat, and how many grams (g) of fiber each serving has:
- Bran cereal (1/3 cup): 8.6g
- Kidney beans (1/3 cup): 7.9g
- Lentils (½ cup): 7.8g
- Black beans (½ cup): 7.6g
- Chickpeas (½ cup): 5.3g
- Baked beans (½ cup): 5.2g
- Pear (1 medium): 5.1g
- Soybeans (½ cup): 5.1g
- Sweet potato, with skin (1 medium): 4.4g
- Green peas (½ cup): 4.4g
- Bulgur (½ cup): 4.1g
- Mixed vegetables (½ cup): 4g
- Raspberries (½ cup): 4g
- Blackberries (½ cup): 3.8g
- Almonds (1 ounce): 3.5g
- Spinach, cooked (½ cup): 3.5g
- Vegetable or soy patty: 3.4g
- Apple (1 medium): 3.3g
- Dates, dried (5 pieces): 3.3g
For many years, doctors advised people with diverticulosis not to eat nuts, seeds, or popcorn, which they believed could block the openings of diverticula and lead to flare-ups of diverticulitis.
But research has never proven that eating these foods increases the risk of developing diverticulitis, and doctors no longer make this recommendation.
Because foods that are high in fiber are typically also high in vitamins and other nutrients, it’s best to get the fiber you need from food.
But if dietary restrictions prevent you from consuming all the fiber you need at meals, your doctor may recommend fiber supplements.
- Psyllium, which is present in supplements like Metamucil and Konsyl, is one fiber option. This supplement may be sold as a powder or liquid, in granules, capsules, or as a wafer.
- Methylcellulose-based supplements, like Citrucel, are typically sold in powder or granular form.
- Chicory root fiber, inulin, oligofructose, and fructooligosaccharides (FOS) may increase good bacteria and improve immune function.
Other Foods to Help Prevent Diverticulitis
Fiber and good bacteria are key components of a healthy digestive tract. Fiber itself helps promote good bacterial growth, but there are also foods containing active cultures that promote good digestion and prevent constipation that drives diverticulosis.
- Yogurt
- Kefir
- Kimchi
- Miso
- Kombucha