Here's What a Diverticulitis Diet Should Look Like if You're Having an Attack—Or Trying to Prevent One
The best diet for diverticulitis can differ depending on whether or not you're having symptoms. During an acute episode of uncomplicated diverticulitis, a clear liquid diet may be best, experts say. But that's just a short-term fix.
If you're eating to try to prevent a recurrence or stave off this painful gastrointestinal (GI) condition from occurring in the first place, 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 to eat if you're having 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, let alone any desire to bulk up on fiber. Fortunately, experts say it's fine to take it easy on your gut right now.
In the absence of large, randomized controlled trials, doctors traditionally have recommended a period of bowel rest during an acute, uncomplicated attack—and that advice persists. 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 tells 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."
According to the Cleveland Clinic, a clear liquid diet for diverticulitis can include:
- Clear broths.
- Clear (no-pulp) juice.
If you feel like adding solids to your diet more quickly, AGA says that's fine. In fact, one small study suggested that a liquid diet isn't necessary during the acute phase of diverticulitis, and a review of published studies 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," says Dr. Strate. For the typical outpatient (meaning you're not being treated in the hospital), she suggests starting with clear liquids before moving on to foods like applesauce and rice.
Once you're able to eat solid foods again, start with a low-fiber diet, UCSF Health suggests. Options include:
- Canned or cooked fruits or veggies (without the seeds or skin).
- Dairy (cheese, milk, yogurt).
- Low-fiber cereal.
- Well-cooked ground or tender meat.
- 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, 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 or seed butters.
- 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, notes the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). But it's not meant as a replacement for a high-quality diet.
How much fiber do you really need?
Low fiber intake is considered a risk factor for diverticulitis. Yet most people in the US fail to get enough fiber in their diets. Based on federal 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.
RELATED: 30 Best Foods With Fiber
What to eat to prevent a diverticulitis attack
If you've tangled with diverticulitis before, or you've been told you may be at risk of developing this painful GI condition because you have diverticulosis, boosting fiber intake is key. About 15%–20% of people with diverticulosis (or tiny pouches along the wall of the colon) will go on to develop diverticulitis during their lifetime, per Harvard Health.
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, says Harvard Health. And it may also reduce pressure in the colon and help prevent diverticulitis flare-ups. Examples of high-fiber foods include:
- Whole wheat bread.
- Whole grain cereals, such as oatmeal.
- Brown rice and wild rice.
- Whole wheat pasta.
Patients often worry about consuming high-roughage foods, even when they're feeling well, due to fear of another attack, Warren tells Health. But since fiber intake is extremely important, 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," says Warren. Plus, following this dietary pattern would naturally limit a person's intake of added sugar, processed foods, and saturated fat from animal proteins, she explains.
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), may be a good way to prevent another episode, Dr. Strate says.
Switching to a vegetarian diet is another option for boosting your fiber intake, she says, 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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