Vegetables are good for you; there's no denying that. But when you're having a diverticulitis flare-up, they can make matters worse. The good news is that, if you have diverticular disease, diet changes like avoiding vegetables can help you manage the condition and give you some relief.
However, when the flare-up and inflammation are back under control, reintroducing fiber-rich vegetables slowly into your diet can help reduce the risk of having a recurrent attack.
Diverticulosis Versus Diverticulitis
Diverticulosis and diverticulitis are two terms that are often used interchangeably, but although both conditions fall under the umbrella of diverticular disease, they're vastly different.
Diverticulosis describes a condition in which you have small pouches (called diverticula) in the lining of your digestive tract, usually your large intestine or colon. Diverticulitis is a more serious problem that occurs when these pouches become inflamed or infected.
To fully understand the difference, it's helpful to back up a little bit and explain how the pouches associated with diverticular disease develop. When you're born, your intestines are smooth and free of any bulges or pouches. However, as you age, increased internal pressure on your intestinal wall can push out against the lining of your digestive tract and create one or several bulges.
According to the American Society for Gastrointestinal Endoscopy, approximately half of the American population has diverticulosis by the time they reach 60. After the age of 80, almost everyone has some pouches. While most people who have diverticula don't even realize it because they don't have any symptoms, about 20 percent of people with diverticulosis experience a complication, like diverticulitis.
Symptoms of Diverticulitis
If the pouches become inflamed or infected and diverticulitis does develop, it's likely that you'll experience some uncomfortable digestive symptoms. The most common symptom is abdominal pain, usually characterized by soreness or sensitivity on the left side. Other possible symptoms include:
If you're experiencing these symptoms and you suspect diverticulitis, check in with your doctor to confirm or rule out the diagnosis. If diverticulitis is confirmed, your doctor may recommend a specialized diet (along with other treatments, if necessary) during your flare-up.
Foods to Avoid
If you have diverticular disease, diet can be an invaluable tool in managing flare-ups and the symptoms that come with them. In the beginning stages of your flare-up, you'll have to avoid all vegetables and all solid foods, completely.
Your doctor will likely prescribe a short-term, clear liquid diet to take the stress off your digestive system and allow the inflammation to come down. When following a clear liquid diet, you must avoid all solid food, but you can have:
- Clear juices, like apple, cranberry and grape (with no pulp)
- Ice pops
Although there are a lot of foods to avoid for diverticulitis, the Mayo Clinic notes that, once you start feeling better, your doctor will let you know when you can progress to eating some solid, low-fiber foods again.
When you get the green light, you'll still have to avoid eating raw vegetables, but you'll be able to safely include well-cooked and canned vegetables in your diet as well as other low-fiber foods, like eggs, cheese, yogurt, cooked fruit, poultry and ground meat.
Once symptoms improve, usually after two to four days, you can slowly add fiber back into your diet, limiting your intake to five to 15 grams per day. Once symptoms are completely resolved, you can switch to a high fiber diet, making sure to include a variety of vegetables.
Fiber and Diverticulosis
Because the prevalence of diverticulosis is lower in areas where people follow a high-fiber diet, many health care professionals believe that the condition develops, at least in part, as a result of not getting enough fiber. When you don't eat enough fiber, waste doesn't move through your digestive system as easily and constipation can develop. If this happens, it increases pressure in the intestines.
The increased pressure (and straining to go to the bathroom that's associated with constipation) can lead to diverticulosis. However, when you eat fiber, it pulls water into your stool, softening it and making it easier to pass so you can reduce the pressure on your intestinal wall, simultaneously reducing your risk of diverticulitis. That's why following a high-fiber diet after your diverticulitis symptoms have resolved may help prevent future attacks.
Diverticular Disease Diet
Although the amount of fiber your doctor recommends for you may be different from the general recommendation, experts typically suggest getting between 20 and 35 grams of fiber every day to keep your bowels regular and to reduce the risk of a diverticulitis attack.
You can increase your fiber intake by eating lots of fiber-rich vegetables, like green peas, broccoli, collard greens, baked potatoes (white and sweet), Brussels sprouts and cauliflower. If you find that you don't tolerate raw vegetables well, you can make them easier on your digestive tract by cooking them first.
- Chia seeds
- Brown rice
- Fruit (with the skin, if you can tolerate it)
Slowly Increase Your Fiber Intake
If you're not used to getting a lot of fiber, or you're coming off a recent diverticulitis flare-up, it's best to increase your intake of fiber gradually, instead of all at once. Eating too much fiber too soon can cause uncomfortable symptoms, like gas and bloating. Instead, increase your intake slowly over a period of two weeks to give your body time to adjust to your new diet.
Make sure you're also drinking enough water. Water helps your body use fiber to keep your stools soft and bulky. Jacqueline Wolf, MD, an associate professor of medicine at Harvard Medical School, recommends drinking between eight and nine glasses of water per day and getting regular exercise to help keep things moving.
While this general diet plan works well for many people, everyone is different. The National Institute of Diabetes and Digestive and Kidney Diseases recommends paying close attention to your symptoms and how you feel. If you notice that certain vegetables or high-fiber foods bother you or worsen your symptoms, cut them out of your diet and find different foods or fiber supplements like bran and psyllium to help you meet your fiber needs.
- Mayo Clinic: "Diverticulitis Diet"
- International Foundation for Gastrointestinal Disorders: "Diverticula, Diverticulosis, Diverticulitis: What's the Difference?"
- American Society for Gastrointestinal Endoscopy: "Understanding Diverticulosis"
- Cleveland Clinic: "Diverticular Disease"
- Johns Hopkins Medicine: "Diverticular Disease"
- UCSF Health: "Diverticular Disease and Diet"
- National Institute of Diabetes and Digestive and Kidney Diseases: "Eating, Diet, & Nutrition for Diverticular Disease"
- Mayo Clinic: "Chart of High-Fiber Foods"
- Harvard Health Publishing: "Rethinking Fiber and Hydration Can Lead to Better Colon Health"