If you’ve ever experienced lower abdominal pain and/or bloating, tenderness, or constipation, your doctor may have diagnosed you with diverticular disease. Also called diverticulosis, the condition is diagnosed by the presence of one or more diverticulum, which is a small pouch pushing out of the lining of the colon wall. Diverticular disease now affects at least half of Americans over age 60, but younger adults can also be affected.
Diverticulitis occurs when one of these small pouches becomes inflamed. This may progress to bleeding, an abscess, or intestinal obstruction. If your physician suspects you may have diverticulosis or diverticulitis, he or she may use your medical history, a physical exam, and tests such as x-rays or colonoscopy, to diagnosis these conditions.
Diverticulitis is treated with a temporary clear liquid diet or low-fiber diet and antibiotics. Once the inflammation or infection is treated and the colon achieves remission, the dietary recommendation is to gradually progress to a high-fiber diet.
Historically, diverticulitis patients were told to avoid high-fiber foods like nuts and seeds. While this is true during a flare-up, the long-term goal is to gradually advance to a high-fiber diet. Today, there is strong evidence that a high-fiber diet – including fruits with small seeds – can help prevent another bout of diverticulitis.
This may come as a surprise to some people. However, fiber softens the stool and speeds its passage through the colon. Fiber-rich foods like whole grains, fruits, vegetables, and legumes help to lower inflammation. This all reduces pressure on the intestinal wall, reducing the risk of flare-ups.
Once your physician gives you the OK to advance to a high-fiber diet:
- Add fiber into your diet gradually.
- Make sure to drink more fluids as you add fiber. Aim for at least 8 cups of water each day.
- Eat small, frequent meals and snacks.
- Chew your food well and take small bites.
- Avoid fatty foods like processed meats, heavy cheeses, and fried foods, and eat lean proteins like fish, white meat poultry with no skin, lean cuts of meat in moderation and small portions, and eggs.
Eat fresh fruits and vegetables
Patients can progress from eating canned or well-cooked (lower fiber) vegetables and fruits with no skin, to eating mostly fresh produce. Try adding one serving of a fresh fruit or vegetable each day. Aim for 4-5 servings of fruits and vegetables each day.
Mix your grains
Mix some high-fiber cereal or oatmeal with your lower-fiber cereal, like corn flakes. Try incorporating some whole wheat pasta and rice brown rice. Instead of choosing only white breads, try incorporating at least 1 slice of whole wheat bread per day.
As long as you are tolerating high-fiber grains and fresh produce, try adding ½ cup of beans, peas, or lentils each day.
Eat a few small servings of nuts or seeds each week, such as almonds, walnuts, cashews, or pumpkin seeds.
Use whole wheat flour
Replace one-third of all purpose flour with whole wheat flour when following recipes.
Consider a fiber supplement
Talk to your doctor about adding a serving of a psyllium-based fiber product like Metamucil® each day, to determine if it would be beneficial for you, but don’t let it replace your intake of high-fiber foods.
Additionally, probiotic-rich foods, such as yogurt with “live active cultures” or kefir, may also be beneficial. Achieving a healthy body weight and exercising are other strategies that can help manage diverticular disease.
To learn more about nutrition services offered at South Shore Medical Center, click here.