When it comes to diet and disease, the professionals don't always get it right. Not too long ago, if you had the chronic digestive condition, diverticulosis, you were told you couldn't eat fruits with seeds; otherwise, you were putting yourself at risk of developing the acute condition known as diverticulitis. While you do need to avoid many foods when you have diverticulitis, including most whole and fresh fruits, it's highly doubtful that fruits with seeds cause your flare-ups.
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What Is Diverticulosis?
While fruit may not cause diverticulitis, not eating enough fruit — and other high-fiber foods — may increase your risk of developing pockets or pouches in your colon referred to as diverticula, according to MedlinePlus. If it's discovered that you have these diverticula pockets in your colon, then you have a condition known as diverticulosis.
Diverticulosis is very common, affecting nearly 50 percent of U.S. adults over age 60, according to MedlinePlus, and your risk of developing the digestive condition increases as you get older. Very rarely do your diverticula alone cause symptoms, but some people experience constipation, bloating, or mild pain that can be alleviated with a high-fiber diet and over-the-counter pain relievers.
In most cases, you may not even realize you have diverticulosis until you've completed your colon cancer screening test that's usually conducted around age 50. A colonoscopy is often conducted to do the screen and generates images of your colon that find the diverticula pockets.
What Is Diverticulitis?
You may not have any problems from your diverticulosis. However, if your diverticula become inflamed or infected, you may experience severe abdominal pain, nausea, vomiting, diarrhea and possibly a fever. When your diverticula become inflamed, it's referred to as diverticulitis, an acute condition.
You should seek immediate medical attention if you're experiencing constant, unexplained abdominal pain, especially if it's accompanied by a fever, nausea, vomiting or diarrhea.
Treatment for diverticulitis varies, but if you have a mild case, your doctor may prescribe an antibiotic and recommend you follow a special diet that allows your colon to rest and heal.
In severe cases, you may need to be hospitalized so you can get antibiotics intravenously and have your infected diverticula drained. If your diverticulitis is recurrent or your bowel is obstructed, surgery may be necessary to remove the affected portion of your colon.
Read more: Diverticulitis and Colonoscopy
Eating With Diverticulitis
During an acute flare-up of diverticulitis, you may need to avoid all whole and fresh fruits — and most other foods for that matter. Initially, your doctor may recommend a clear liquid diet, which will keep you hydrated while your colon gets some rest, but offers very little nutritional value. You should follow a clear liquid diet for only a few days.
On a clear liquid diet, you can have:
- Clear juice such as apple juice or cranberry juice
- Popsicles or fruit ice
- Black coffee or tea
You can also use sugar or honey while following your clear liquid diet.
Once your symptoms have improved, your doctor may suggest you add more solid, easy-to-digest foods to your diet, such as:
- Canned fruits
- Soft, cooked vegetables such as potatoes without skin and carrots
- Chicken, fish and eggs
- Milk and yogurt
- White pasta and rice
- Low-fiber cereal
This diet is also referred to as a low-fiber or low-residue diet and can help you meet more of your nutritional needs while you continue to recover from your diverticulitis. As your symptoms resolve, you can slowly return to your regular diet as advised by your doctor.
Diverticular Disease Diet
It may take nothing more than experiencing one episode of diverticulitis for you to make the necessary dietary changes that help prevent flare-ups. The diverticular disease diet focuses on fiber. Adding more fiber to your diet helps soften your stool to reduce pressure on your colon, which may help prevent the diverticula flare-ups that lead to diverticulitis.
Fiber is a type of carbohydrate that your body can't digest. It fills your stomach and keeps you full without costing calories and adds bulk to your stool to help keep your colon clean and healthy. Getting more fiber in your diet does more than prevent a bout of diverticulitis; it may also make it easier for you to manage your weight, lower your risk of heart disease and help keep your blood sugar levels steady to maintain energy.
How Much Fiber?
If you're like most Americans, you're probably not getting enough fiber in your daily diet. According to results of the most recent National Health and Nutrition Examination Survey, published in 2017, Americans get about 16 grams of fiber a day, on average. Adults need between 25 and 38 grams of fiber a day to get the health benefits.
Fruits are an excellent source of fiber and shouldn't be avoided on your diverticular disease diet, even the fruits with seeds, such as raspberries, blackberries and strawberries.
Other high-fiber foods to add include:
- Beans, lentils and peas
- Vegetables, including broccoli, cauliflower and corn
- Whole grains such as brown rice, quinoa and oatmeal
- Whole-wheat pasta
- Nuts and seeds
If you typically don't get enough fiber in your diet, then you want to go slow when increasing your intake to prevent any unnecessary stomach upset. Adding too much fiber too quickly can lead to abdominal pain, gas, bloating and constipation.
You should also take care to drink enough water. While water needs vary depending on your activity level, overall health and the weather, Clemson Cooperative Extension recommends adults aim for eight to 12 cups of water a day.
Nuts, Seeds, Popcorn and Diverticulosis
Up until about 2008, it was generally recommended that if you were diagnosed with diverticulosis, you should avoid nuts, seeds, corn and popcorn, and all foods that contained them. It had been theorized that these foods could potentially injure the lining of your colon and increase your risk of developing diverticulitis. However, despite these recommendations, there is no evidence to support the theory or need for restriction.
In 2008, JAMA published results from the Health Professionals Follow-Up Study, for which 47,000 men completed medical questionnaires every two years and diet questionnaires every four years regarding the association between consumption of these colon-injuring foods and diverticular disease. According to the authors of the study, there was no evidence linking the consumption of nuts, seeds, corn and popcorn to an increased risk of the common digestive condition. They suggested that recommendations to avoid these foods be reconsidered.
More recently, a 2017 review published in Current Opinion in Clinical Nutrition and Metabolic Care agreed with the earlier findings. The authors of this review also noted that increasing your intake of fish and decreasing your intake of meat may help prevent diverticulitis but that more research was needed regarding these additional links between diet and diverticular disease.
Read more: Diverticulosis and Strawberries
- Mayo Clinic: Diverticulitis Diet
- Mayo Clinic: Diverticulitis: Can Certain Foods Trigger an Attack?
- Mayo Clinic: Diverticulitis
- MedlinePlus: Diverticulosis and Diverticulitis
- Centers for Disease Control and Prevention: What Is Colorectal Cancer Screening?
- Academy of Nutrition and Dietetics: Fiber
- NCHS Nutrition Data: NCHS Fact Sheet 2017
- University of California San Francisco: Diverticular Disease and Diet
- Clemson Cooperative Extension: Fluid Needs
- Current Opinion in Clinical Nutrition and Metabolic Care: Dietary Pattern and Colonic Diverticulosis
- JAMA: Nut, Corn, and Popcorn Consumption and the Incidence of Diverticular Disease