Managing Diverticulitis Through Diet

The best diet for diverticulitis can differ depending on whether you're having symptoms, recovering, or trying to prevent an attack. 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 a break down of dietary advice for people who experience symptoms of diverticulitis.

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.

Acute Attack

During an acute, uncomplicated attack, bowel rest may be the best option. The American Gastroenterological Association (AGA) advised people to go on a clear liquid diet "with the goal of patient comfort."

During an acute episode, "patients often feel poorly when they eat," said Lisa Strate, MD, a gastroenterologist and professor of medicine at the University of Washington in Seattle. "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 up to it, you can add solids to your diet. In fact, a small study in Colorectal Disease suggested that a liquid diet isn't necessary during the acute phase of diverticulitis, and a 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, you should start with a low-fiber diet. This can include:

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

Chronic Symptoms

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. Sources of soluble fiber include:

• Oat bran
• Nuts
• Seeds
• Beans
• Lentils
• Peas

While sources of insoluble fiber include:

• Wheat bran
• Vegetables
• Whole grains

Taking a fiber supplement can also boost your dietary fiber intake. 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, adults ought to aim for 22–34 grams of fiber per day, depending on their age and sex.

Ultimately, the AGA recommended 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 blueberries to your breakfast, for example, boosts fiber intake by almost 4 grams. While a half-cup of baked beans packs about 10 grams of fiber.

Diet to Prevent a Diverticulitis Attack

Increasing 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.

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
• Fruits
• Vegetables
• Whole wheat pasta

Patients often worry about consuming high-fiber foods, even when they're feeling well, due to fear of another attack, Warren said. 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 said.

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 more health risks 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.

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.