From the Guidelines
During a diverticulitis flare-up, follow a clear liquid diet initially, then transition to a low-fiber diet as symptoms improve, as recommended by the most recent guidelines 1. When managing diverticulitis, it's essential to consider the latest evidence-based recommendations to minimize morbidity, mortality, and improve quality of life.
- The initial dietary approach should focus on a clear liquid diet to reduce irritation to the inflamed diverticula and promote easier digestion.
- As symptoms improve, the diet can be advanced to a low-fiber diet, including foods like white bread, white rice, pasta, eggs, lean meats, fish, poultry, and well-cooked vegetables without skins or seeds.
- High-fiber foods, nuts, seeds, popcorn, raw vegetables, and tough meats should be avoided until symptoms improve, based on the principle of minimizing irritation and promoting healing.
- Once the acute phase passes, typically after a few days to weeks as directed by a healthcare provider, fiber can be gradually reintroduced into the diet, aiming for 25-35 grams daily through fruits, vegetables, whole grains, and legumes, to help prevent future flare-ups by promoting regular bowel movements and reducing pressure in the colon.
- Staying well-hydrated by drinking plenty of water is also crucial throughout the management of diverticulitis. The rationale behind this dietary approach is supported by the latest clinical practice updates and guidelines, which emphasize patient comfort and the prevention of complications 1. It's also important to note that while certain foods were once thought to exacerbate diverticulitis, such as nuts and popcorn, more recent evidence suggests that these may not need to be strictly avoided 1. However, the primary focus should remain on following a clear liquid diet initially, then transitioning to a low-fiber diet, and eventually reintroducing fiber, all under the guidance of a healthcare provider, to ensure the best outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Dietary Recommendations for Diverticulitis
When managing diverticulitis, dietary choices play a significant role in alleviating symptoms and preventing complications. The following are key points to consider:
- A clear liquid diet is often recommended for patients with uncomplicated diverticulitis, as it helps reduce symptoms and allows the bowel to rest 2, 3, 4, 5.
- A high-fiber diet may be beneficial in preventing diverticulitis recurrence and improving symptoms in patients with diverticular disease 2, 6.
- Certain foods may increase the risk of diverticulitis, such as high alcohol intake and consumption of unprocessed red meat 6.
- On the other hand, higher consumption of poultry and fish may not increase the risk of diverticulitis, and fish intake may even be associated with a reduced risk 6.
Treatment Approaches
Treatment for diverticulitis typically involves a combination of dietary changes, antibiotics, and rest. Key points to consider:
- Outpatient treatment with oral antibiotics and a liquid diet has been shown to be safe and effective for patients with uncomplicated diverticulitis 3, 4.
- Inpatient treatment with intravenous antibiotics may be necessary for patients with complicated diverticulitis or those who do not respond to outpatient treatment 2, 3.
- Lifestyle modifications, including dietary changes and patient education, are critical in preventing complications and improving outcomes for patients with diverticular disease 5.