Foods You Can or Can't Eat When You Have Diverticulitis
|Expert Reviewed||Dr. Keith Kantor, Ph.D. in Nutritional Science|
Are There Foods I Should Avoid If I Have Diverticulitis?
The general advice is to adopt the diverticulitis diet. Avoid foods that are high in fiber (residue) when you have a diverticulitis attack, and once the symptoms go away, slowly increase your fiber intake to restore regular bowel movements and reduce the risk of future flare-ups.
In the past, doctors would advise patients with diverticulitis to avoid certain foods that were thought to increase gut inflammation and worsen the condition. These foods included nuts and seeds, popcorn, some vegetables and fruits, whole wheat, acidic, sugary, and fatty foods, and other processed foods. Sounds crazy, right? What can you eat?
The truth is that few studies have looked at what foods are good or bad for diverticulitis, and none have found evidence supporting the need to avoid certain foods. In fact, a 2008 study published in the Journal of the American Medical Association found that nut, corn, and popcorn consumption did not increase the risk of diverticulitis. That being said, each person is unique, and certain foods—particularly foods high in fiber and residues—may still trigger diverticulitis attacks some people. This has lead to mixed advice on what should and shouldn't be eaten.
According to Dr. Keith Kantor, a doctor of nutritional science from Atlanta, "Following the three phases (of the diverticulitis diet) is a great idea to gently reintroduce high-fiber foods." When reviewing the recommended foods below, Dr. Kantor recommends finding the least processed (most natural) versions to avoid other harmful effects. For example, sports drinks are recommended when you have a diverticular flare-up because they provide hydration and electrolytes, but opt for natural sports drinks that do not use dyes, syrups, or preservatives.
Foods to Eat and Foods to Avoid With Acute Diverticulitis
Foods to Eat (Liquids and Low Fiber)
Foods to Avoid (High Fiber)
Soup stock or broth
Whole-wheat and whole-grain foods
Gelatin, apple sauce
Ice chips or ice pops
Oatmeal, barley, quinoa
Seeds (sesame seeds, chia seeds, etc.)
Foods made with white flour
Nuts (peanuts, almonds, Brazil nuts, etc.)
Peanut butter and other nut butters
Low-fiber cereals (Cream of Wheat)
Canned or well-cooked fruits and vegetables w/o skin
Fruit and vegetable juices without pulp
Raw vegetables and fruits with skins
Milk and other dairy products (if not lactose intolerant)
Dried fruits and prune juice
Tea or coffee w/o sweetener
Bacon, shrimp, and other meats
How Is Diverticulitis Treated?
In mild cases, diverticulitis may go away on its own, or your doctor may prescribe oral antibiotics (intravenous antibiotics if the condition is severe) and put you on the diverticulitis diet.
What Foods Can I Eat If I Have Diverticulitis?
The Diverticulitis Diet
The purpose of the diverticulitis diet is to allow your digestive system to reset and rebuild its health. Initially, you will cut out fiber intake to reduce the symptoms, after which, you will gradually increase your fiber intake as symptoms improve over the course of a few days.
There are three stages: clear liquids, low-fiber foods, and high-fiber foods.
Stage 1: Clear Liquids (~1-2 days)
- Ice chips or ice pops
- Ice cream or milkshakes
- Broth, preferably low in sodium
- Fruit juices
- Tea or coffee without sweeteners
Stage 2: Low-Fiber/Low-Residue Foods (~2-3 days)
- White bread
- White rice
- Low-fiber cereals
- Peeled and cooked or canned vegetables/fruits
- Dairy (milk, yogurt, cheese)
- Fish, chicken, and eggs
- Fruit or vegetable juice (no pulp)
Stage 3: High-Fiber Diet
- Whole wheat and whole grain foods
- Fruits and vegetable with skin
- Brown rice
- Nuts (peanuts, Brazil nuts, etc.)
- Sesame, chia, hemp seeds
- Psyllium powder
Risks of the Diverticulitis Diet
Because of the reduced food intake, especially in the first few days, you may not be getting enough nutrients. Speak to your doctor to determine if this diet is safe for you. In most cases, they may supplement those nutrients using an IV.
Although increasing daily fiber intake can help soften stool and facilitate bowel movements, increasing too quickly can cause discomfort, pain, and increase gas (flatulence). It is important to transition to a high-fiber diet only when no symptoms are present with a low-fat diet or when your doctor determines your diverticula are no longer inflamed.
What is the reasoning behind these dietary restrictions?
Diverticulosis vs. Diverticulitis
Diverticulosis is when small pouches (diverticula) form due to the bulging of the intestines—usually the colon—out of the outer intestinal lining. There is currently no consensus on what causes diverticulosis, but there are two possibilities: 1) excessive strain causing pressure to build up (similar to a hernia), and 2) not eating enough fiber.
This is a common condition and is generally asymptomatic—most people don't even notice them.
Diverticulitis is the inflammation of one or more of these small pouches. Again, the exact causes are unclear, though doctors agree that there are many possible contributing factors, including low-fiber diet, lifestyle, genetics, and age.
Symptoms of Diverticulitis:
- Abdominal pain, especially on the left side
- Blood in stool
- Diarrhea or constipation
Benefits of High-Fiber Diet for Digestive Health
Dietary fiber is not digested or absorbed by the body, so it does not contribute any calories. However, fiber can soften and bulk up the stool to ease the passage through the colon. This is why a low-fiber diet is thought to contribute to diverticulosis. Impacted stools require more strain, increasing the risk of forming diverticula.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, if you have diverticulosis, or if you have had diverticulitis, a high-fiber diet may help prevent diverticulitis flare-ups. However, if you have a flare-up, it's best to avoid fiber until symptoms calm down. The added bulk may cause the stool to press against the diverticula, irritating them and causing more pain.
There are two types of dietary fiber:
Soluble fibers are soluble in water and create a pasty, gel-like substance. They help control blood cholesterol and glucose levels. They are also fermentable, meaning they can be digested by your gut microbes to create gas and other byproducts.
List of foods high in soluble fiber:
- Apples and citrus fruits
Insoluble fibers do not dissolve in water and add bulk to the stool, making you feel full quicker and eases the passage of stool. Supplementing with insoluble fiber is popular for weight management and constipation.
List of foods high in insoluble fiber:
- Whole grains
- Whole wheat
- Bran cereal
Frequently Asked Questions
Can Diverticulitis Pain Go Away on Its Own?
Mild cases of diverticulitis may not require treatment. More severe or recurrent cases may require antibiotics and an all-liquid or low-fiber diet until symptoms stop. The pain can generally be managed with acetaminophen (Tylenol). Aspirin and ibuprofen should be avoided because of the risk for upset stomach and internal bleeding.
Can You Prevent Diverticulitis?
Keeping a food journal and maintaining a high-fiber diet can help you avoid flare-ups, although they are not a guarantee.
How Much Fiber Should I Eat Each Day?
According to the Dietary Guidelines for Americans, 2015-2020, adults should eat 28-34 g of dietary fiber every day.
Can You Drink Alcohol If You Have Diverticulitis?
The common advice is to avoid alcohol when experiencing digestive problems. However, according to a recent meta-analysis published in the Hawai'i Journal of Medicine and Health, regular alcohol consumption was not found to be associated with incidences of diverticulosis or diverticular attacks and did not increase the likelihood of being diagnosed with either condition. That being said—like with all other foods in this guide—it's best to consume alcohol in moderation. If you notice any increases in discomfort, stop drinking immediately.
Can You Eat Pizza With Diverticulitis?
It depends on the person. There are no recommendations against eating pizza. In addition, it does not have much fiber, with just 2.5 g per slice of cheese pizza. However, certain toppings like cheese and peppers may increase irritation. Again, each person is different. Keep a food journal to keep track of what works for you. In general, it's best to eat in moderation. If you have any doubts, talk to your doctor or a nutritionist.
Can You Eat Lettuce or Salads With Diverticulitis?
Most raw vegetables and some cooked vegetables (e.g. corn, broccoli, cauliflower, onions, peas) should be avoided, but leafy vegetables may be okay. Again, you can eat a small amount and see how it affects you.
This article is meant as a guide to be used for informational purposes and is not meant to diagnose or treat any condition. It is recommended you speak with your doctor for the best treatment plan for your situation.
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Dr. Keith Kantor
“This article is a great review of what diverticulitis is and its effects on digestion and overall health. The
example of the foods to avoid and the foods to consume were accurate.”