Diverticular disease occurs when diverticula, small pouches, form in the large intestinal wall. Typically the pouches occur from years of a low-fiber diet which results in excessive pressure in the colon from constipation and straining. If the pouches become inflamed and push through weaker spots in the colon’s outer layers, that is called diverticulosis. Inflammation of the diverticula can result in symptoms such as cramping, pain, tenderness, bloating, constipation, or diarrhea- and is called diverticulitis. Certain foods can help manage symptoms, and research also shows maintaining a certain diet can also prevent symptoms. In the event that diverticulitis develops, it is important to shift gears with the foods you eat to help support the colon’s recovery and get symptoms under control. Today we’ll share foods that can help during the different stages of diverticular disease.
A diet that is high in fiber is crucial to help keep bowel movements regular and prevent straining and constipation, which can lead to more advanced stages of the condition. Most people with diverticulosis may not ever have symptoms, but it is still important to incorporate a high-fiber diet to prevent progression of the disease. Western cultures have been found to have significantly higher levels of diverticular disease due to our low fiber diets, so increasing fiber is the first step to prevent and improve this facet of our health.
The Mayo Clinic recommends that women eat at least 21 to 25 grams of fiber a day, while men should aim for 30 to 38 grams a day. Some sources of fiber include:
- Beans and legumes
- Bran, whole wheat bread and whole grain cereals such as oatmeal
- Brown and wild rice
- Fruits such as apples, bananas and pears
- Vegetables such as broccoli, carrots, corn and squash
- Whole wheat pasta
In addition to a high fiber diet, incorporate these tips:
- Drink at least 64 ounces of water a day
- Exercise regularly- it helps keep the digestive track moving
- Eat a variety of food groups, including five or more servings of fruits and vegetables, three of whole grains and a serving of nuts or beans each day
- Limit red meat, processed, and high-fat foods
Years ago, doctors thought that eating corn, popcorn, nuts and seeds could inflame the polyps and cause diverticulitis, but newer research now shows that isn’t accurate. “It’s safe to eat these types of foods, including tomatoes and strawberries with seeds,” registered dietitian Anna Taylor, MS, RDN, LD explains. “All that normal roughage and fiber is fine.” You can read more myths and facts about diverticular disease, here. But, the best diet for diverticular disease depends on whether you’re having a flare-up, says Taylor.
The Jackson Siegelbaum gasteroenterology team of Pennsylvania explained that there are several stages of diverticular disease. Each requires fine-tuning your diet to best support (and prevent) any symptoms associated with that stage.
- Quiet, early and moderate diverticulosis: This is where most people are. Your provider may have noted diverticuli during a scan (like a colonoscopy), but potentially it wasn’t perceived as an issue, especially in the absence of symptoms. But this is an opportunity to prevent the diverticuli from developing into diverticulitis. To prevent unnecessary pressure and straining that could result in diverticulitis, incorporate more insoluble plant fiber into your diet at this stage (read more about soluble and insoluble fiber, here), which softens stool and helps keep the digestive track moving. Speak to your provider about how to best add more fiber to your diet, as you’ll want to do this gradually to prevent any bloating and discomfort. Make sure to drink plenty of water and exercise to ease the transition.
- Quiet but advanced, fixed and/or narrowed diverticulosis: In many older people, the diverticulosis has become so severe that the colon becomes fixed, twisted or gnarled by fibrous tissue within the bowel wall. At this stage, the colon is less likely to be massaged back to its normal size. The dilemma here is that large stools can seldom be produced, as the only thing that can get through this narrowed portion of the colon is smaller, even pellet-like stool. Still, it is worth trying small doses of extra food fiber or supplements to see what can be accomplished. Speak to your provider about how to best incorporate fiber if you are at this stage of diverticular disease.
- Diverticulitis: At this stage, one or more of the weak-walled diverticuli has become infected and inflamed. It is important to allow the bowel time to rest and recover. A clear liquid diet is most often recommended, which includes: broth, clear juices (avoid orange juice), Jell-O, and popsicles. Slowly transition to low fiber foods (low fat dairy products like cheese and yogurt, eggs, cooked veggies without skin or seeds, lean meats, pasta) then back to your normal diet. Some have found that a low FODMAP diet (which also benefits some with IBS) may help ease symptoms of diverticulitis as well.
Even if you don’t have a history of diverticular disease, it is important to incorporate fiber into your diet to help your gastrointestinal system, lower cholesterol, help maintain healthy blood sugar levels, prevent heart disease and diabetes, and even decrease the risk of breast cancer. With all these benefits (and more), there is every reason to make sure we incorporate more fiber into our diets. For those living with diverticular disease, fiber can be a crucial tool in helping ease symptoms and prevent the development of more serious complications.