Managing Diverticulitis Through Diet

In some situations, a high-fiber diet is your best friend—in others, maybe not.

The best diet for diverticulitis can differ depending on whether you're having symptoms, recovering, or trying to prevent an attack. During an acute episode of uncomplicated diverticulitis, a clear liquid diet may be best.

To prevent this painful gastrointestinal (GI) condition, a healthy diet full of fiber-rich fruits, vegetables, and whole grains is the way to go.

Here's how the latest dietary advice for diverticulitis breaks down.

What a Diverticulitis Diet Looks Like, According to Experts , Black woman biting sandwich
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What to Eat During a Diverticulitis Attack

When you're dealing with abdominal pain, nausea, or bowel changes due to diverticulitis, you may not have much of an appetite.

Healthcare providers recommend a period of bowel rest during an acute, uncomplicated attack. The latest guidance from the American Gastroenterological Association (AGA) advises a clear liquid diet "with the goal of patient comfort."

During an acute episode, "patients often feel poorly when they eat," Lisa Strate, MD, a gastroenterologist and professor of medicine at the University of Washington in Seattle told Health. "I recommend that they stay on a liquid diet or sort of a BRAT diet [bananas, rice, applesauce, toast] for a couple of days," Dr. Strate said.

A clear liquid diet can include:

  • Clear broths
  • Clear (no-pulp) juice
  • Jell-O
  • Popsicles
  • Water

If you feel like adding solids to your diet more quickly, AGA says that's fine. In fact, a small 2016 study published in Colorectal Disease suggested that a liquid diet isn't necessary during the acute phase of diverticulitis, and a 2018 review published in Nutrients found no research to indicate that bowel rest is even required after an acute episode.

"I think it really has to do with how the patient feels," said Dr. Strate. For the typical outpatient (meaning you're not being treated in the hospital), Dr. Strate suggested starting with clear liquids before moving on to foods like applesauce and rice.

Once you're able to eat solid foods again, a 2020 review published in Current Problems in Surgery suggests you start with a low-fiber diet.

Options include:

  • Canned or cooked fruits or veggies (without the seeds or skin)
  • Dairy (cheese, milk, yogurt)
  • Eggs
  • Low-fiber cereal
  • Well-cooked ground or tender meat
  • Pasta
  • White bread
  • White rice

For patients with active symptoms, Ryan Warren, RD, CDN, a New York City-based registered dietitian and clinical nutritionist specializing in GI health, told Health that she typically encourages a diet that's "very low in roughage" (or texturally "tough" insoluble fiber) but still includes moderate amounts of soft, soluble fiber.

Good, low-roughage sources of fiber include:

  • Naturally soft and/or peeled fruits and vegetables. (Think: banana, avocado, melon)
  • Well-cooked veggies and/or fruits. (Carrots; peeled squash or zucchini; poached, peeled apples or pears)
  • Blended or pureed fruits and veggies. (Examples include soups, smoothies, and baby food)
  • Nut butter or seed butter
  • Easy-to-digest legumes, including hummus, lentil soup, and boiled edamame
  • Easy-to-digest grains, such as oats, millet, buckwheat, and brown rice

Taking a fiber supplement like methylcellulose (Citrucel) or psyllium (Metamucil) can also boost your dietary fiber intake, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). But it's not meant as a replacement for a high-quality diet.

Fiber Guidelines

Low fiber intake is considered a risk factor for diverticulitis. Yet most people in the US don't get enough fiber in their diets. Based on USDA dietary guidelines, adult women ought to aim for 22 to 28 grams of fiber per day, depending on their age. For men, the goal is 28 to 34 grams.

Ultimately, the AGA recommends that anyone with a history of diverticulitis consume a "high-quality diet," including fiber from fruits, vegetables, whole grains, and legumes. Adding a cup of berries to your breakfast, for example, boosts fiber intake by 4 to 8 grams, says the AGA. A half-cup serving of beans or lentils packs 5 to 8 grams of fiber.

Eating to Prevent a Diverticulitis Attack

Boosting fiber intake is key to preventing diverticulitis. You could be at risk if you've tangled with diverticulitis before or if you have diverticulosis. About 15%–20% of people with diverticulosis (tiny pouches along the wall of the colon) will go on to develop diverticulitis during their lifetime, per the 2020 Current Problems in Surgery review.

So what should your diet look like? It's pretty simple, really. A diverticulitis diet looks like any other healthy eating pattern that emphasizes fruits, vegetables, whole grains, and legumes.

A diet that's high in fiber can help prevent constipation. And it may also reduce pressure in the colon and help prevent diverticulitis flare-ups.

Examples of high-fiber foods include:

  • Beans
  • Legumes
  • Bran
  • Whole wheat bread
  • Whole grain cereals, such as oatmeal
  • Brown rice and wild rice
  • Fruits
  • Vegetables
  • Whole wheat pasta

Patients often worry about consuming high-roughage foods, even when they're feeling well, due to fear of another attack, Warren told Health. But since fiber intake is extremely important, Warren said she tries to focus on healthy, safe ways that people can incorporate fiber-rich foods into their diets to keep them in remission.

"I often recommend a Mediterranean-style diet because it encourages a wide variety of real, whole foods and focuses primarily on plant-based foods," explained Warren. Plus, following this dietary pattern would naturally limit a person's intake of added sugar, processed foods, and saturated fat from animal proteins, Warren told Health.

Per US dietary guidelines, there's little room for red and processed meats, sugar-sweetened foods and beverages, and refined grains in a healthy diet. Higher intake of these foods is associated with "detrimental health outcomes," and diverticulitis is no exception.

Decreasing the amount of fat in your diet, particularly red meat (a risk factor for diverticulitis), might be a good way to prevent another episode, Dr. Strate said.

Switching to a vegetarian diet is another option for boosting your fiber intake, Dr. Strate explained, adding that some studies suggest the diet is related to a decreased risk of diverticulitis.

Whichever diet you choose, it's best to bump up your fiber intake gradually—adding 5 grams per week until you reach your goal. Increasing the amount of fiber in your diet in a measured way will help to reduce gas and bloating.

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