A routine colonoscopy every 10 years starting at age 45 is an important part of our internal self-care that lets us take a rare look at the inside of our digestive tract at the large intestine (or colon). One of the things doctors most commonly observed during a colonoscopy are diverticula – or small pockets formed on the lining of our colon. In fact, 58% of adults over 60 have this condition, known as diverticulosis. Diverticula form when there is pressure applied to weak spots in the intestinal wall through the normal process of digestion overtime that causes an outward bulge of the wall. The presence of diverticula isn’t problematic by itself, and most people won’t ever experience any issues. However, food seems to play a role in either increasing or decreasing the risk for complications that change diverticulosis into diverticulitis.
When Diverticulosis Becomes Diverticulitis
Diverticulitis is the evil twin of diverticulosis. The change to the ‘itis’ suffix means inflammation of the diverticula. This is when symptoms like abdominal pain, fever, or blood in your stool will crop up. The vast majority of people with diverticulosis will stay in the dormant state of the condition. But when it flares into diverticulitis, it could be severe enough to land you in the hospital.
We don’t know exactly what causes the diverticula but eating habits that put you at a higher risk include eating low fiber and a lot of red meat.
Although these conditions are two sides of the same coin, our body has very different needs when the inflammation switch is on versus off.
Best Foods for Diverticulitis
When your colon is in the inflamed, symptomatic state of diverticulitis, otherwise known as a flare, clear liquid foods are recommended to give your gut a break while staying hydrated. This includes water, broth, gelatin, popsicles, tea and juices. Avoid versions of these products that have solid chunks of food or pulp in them. This is a very temporary diet (i.e. a few days) as it will not meet your nutrition needs. The goal of this stage is to give your gut a rest.
As symptoms subside, the next step is reintroduction of a low fiber or “fiber modified” diet, which should be around 10 to15 grams of fiber per day. At this stage it is still beneficial to avoid foods like raw vegetables, whole grains, beans, processed meat, nuts, produce with seeds and dried fruit. Spicy and fried foods are also not recommended. Foods that fit into this eating pattern include:
- Fruits: canned fruits in 100% juice or water, applesauce, bananas, melons
- Limited vegetables (all well-cooked): beets, carrots, zucchini, pumpkin, potatoes (without the skin)
- Dairy: yogurt, cottage cheese, milk, cheese
- Grains: refined grains like white rice, white bread and white pasta
- Protein: tender and soft meats, fish, chicken, eggs, tofu, smooth peanut butter
- Fat: smooth sauces and dressings, avocado
Best Foods for Diverticulosis
Once you have recovered from a flare, the next goal is to advance your diet back up to the recommended fiber amounts (25 grams a day for women and 38 grams a day for men) over the course of a few weeks.
It’s important to work back up to normal fiber levels and not restrict fiber long- term because fiber appears to actually reduce the risk of a diverticulitis flare and other diverticula complications!
While temporarily eating lower fiber can help give the gut a rest in the short term, fiber fortifies our colon health in the long term. Learn more about many additional the benefits of fiber in our previous blog post here.
High fiber foods to add back in your regular diet to promote colon health include the following foods with 4 grams or more fiber per serving:
- Whole grains including whole wheat products, oatmeal, brown rice, quinoa, barley, farro
- Dried or canned beans
- Nuts and seeds, particularly almonds and flax seeds
- Vegetables with skins and seeds, including raw and cooked
- Fruits with skins and seeds including berries, dried fruit, apples and pears
Wherever there is fiber there should also be fluid! Keeping hydrated and drinking plenty of water as you increase your fiber will ensure the fiber is able to move comfortably through your digestive tract.
Changing Recommendations To Note
It used to be common practice for providers to recommend restricting nuts, seeds, corn and popcorn at all times if diverticulosis was present regardless of the state of the colon. It was thought that these foods may get caught in the diverticula pockets and build up, triggering inflammation. However, there is not good evidence to support this recommendation. In fact, these and other high fiber foods appear to reduce the risk of diverticulitis recurrence. While these foods would still be irritating in an active flare, you can enjoy these foods when you have diverticulosis.
Avance Care Nutrition Services
A Dietitian can help you navigate the various changing fiber recommendations that come with managing a diverticular condition. Book an appointment online by visiting here, or call 919.237.1337, option 4 today with one of our Avance Care Dietitians!
Sources:
American Dietetic Association. Nutrition Care Manual®. [Diverticular Conditions]. [https://www.nutritioncaremanual.org/topic.cfm?ncm_category_id=1&lv1=5522&lv2=275035&lv3=275046&ncm_toc_id=275046&ncm_heading=Nutrition%20Care]. Accessed [November 19, 2024].
Strate LL, Liu YL, Syngal S, Aldoori WH, Giovannucci EL. Nut, Corn, and Popcorn Consumption and the Incidence of Diverticular Disease. JAMA. 2008;300(8):907–914. doi:10.1001/jama.300.8.907
