Can I take high protein Ensure (Nutritional Supplement) during a diverticulitis flare-up while on a clear liquid diet?

High Protein Ensure During Diverticulitis Flare-Up

High protein Ensure should not be consumed during a diverticulitis flare-up when on a clear liquid diet, as it is not considered a clear liquid and may exacerbate symptoms during the acute phase. 1

Clear Liquid Diet During Acute Diverticulitis

The American Gastroenterological Association (AGA) recommends a clear liquid diet during the acute phase of uncomplicated diverticulitis 1. Clear liquids are those you can see through at room temperature, which typically include:

• Water
• Clear broths
• Clear fruit juices without pulp (apple, cranberry)
• Clear sodas
• Tea or coffee without milk
• Clear sports drinks
• Plain gelatin

High protein Ensure is a milk-based nutritional supplement that contains proteins, fats, and other nutrients that make it opaque, classifying it as a full liquid rather than a clear liquid.

Dietary Progression for Diverticulitis

The dietary approach for diverticulitis follows a specific progression:

1. Acute Phase (Flare-up): Clear liquid diet for 2-3 days 1, 2
2. Improvement Phase: Gradual advancement to full liquids and then low-fiber foods
3. Recovery Phase: Transition to a high-fiber diet (25-35 grams daily) as symptoms resolve 1

According to the AGA guidelines, patients should advance from a clear liquid diet to a regular diet within 3-5 days as symptoms improve 1. This means that high protein Ensure could be incorporated during the transition to full liquids after the acute phase has begun to resolve.

Evidence on Dietary Restrictions

It's worth noting that dietary restrictions during diverticulitis are somewhat controversial:

• A study published in the International Journal of Colorectal Disease found that more restrictive diets were associated with longer hospital stays 3
• More liberal diets (liquid diet or solid foods) were associated with earlier discharge compared to clear liquid diet or nil per os 3

However, the standard of care during acute flare-ups still remains a clear liquid diet initially, with progression as symptoms improve 1, 2.

When to Reintroduce Ensure and Other Nutritional Supplements

You may safely introduce high protein Ensure:

• After 2-3 days on clear liquids when symptoms begin to improve
• When transitioning to a full liquid diet before advancing to solid foods
• When your healthcare provider indicates it's appropriate to advance your diet

Long-term Dietary Considerations

Once the acute flare-up resolves, focus on:

• Gradually increasing fiber intake to 25-35 grams daily 1
• Considering psyllium fiber supplements (15g daily) 1
• Avoiding diets high in sweets and low in fiber 1
• Maintaining adequate hydration

Important Cautions

• Monitor for worsening symptoms when advancing diet
• If symptoms worsen after introducing Ensure or other full liquids, return to clear liquids and contact your healthcare provider
• Antibiotics should be reserved for specific cases such as those with systemic symptoms, persistent fever, increasing leukocytosis, or certain high-risk conditions 2

Following these dietary guidelines can help manage your diverticulitis flare-up effectively while ensuring proper nutrition during recovery.