What foods are good to eat with diverticulitis?

Foods Good to Eat with Diverticulitis

For diverticulitis, a clear liquid diet is recommended during the acute phase, followed by advancement to a high-fiber diet (25-35 grams daily) as symptoms improve to reduce the risk of recurrence. 1

Dietary Recommendations for Different Phases of Diverticulitis

Acute Phase (Active Diverticulitis)

• Clear liquid diet is advised during the acute phase of uncomplicated diverticulitis 1
• This includes:
  • Water
  • Clear broths
  • Gelatin
  • Ice pops without fruit pieces
  • Clear fruit juices (no pulp)
  • Tea or coffee without cream

Recovery Phase (3-5 days after symptoms improve)

• Gradually advance to a regular diet as symptoms improve 1
• Start with low-fiber foods that are easy to digest:
  • White bread, pasta, and rice
  • Well-cooked vegetables without skins or seeds
  • Lean proteins (fish, poultry, eggs)
  • Fruit without skins or seeds

Maintenance Phase (After Recovery)

• High-fiber diet (25-35 grams daily) is recommended to prevent recurrence 1, 2
• Focus on:
  • Whole grains (brown rice, whole wheat bread, oatmeal)
  • Fruits with skins (apples, pears, prunes) 3
  • Vegetables (especially leafy greens)
  • Legumes (beans, lentils)
  • Nuts and seeds (contrary to old myths) 4, 5

Evidence-Based Dietary Approaches

The American Gastroenterological Association recommends a "prudent dietary pattern" that is high in fiber from fruits, vegetables, whole grains, and legumes, and low in red meat and sweets 2. Research has shown that:

• Higher intake of dietary fiber is associated with a lower risk of diverticulitis in women 3
• Fiber from fruits and cereals, but not vegetables, was specifically associated with decreased risk 3
• Whole fruits, especially apples, pears, and prunes, are associated with reduced risk 3
• The old recommendation to avoid nuts, seeds, corn, and popcorn has been debunked 2, 4, 5

Fiber Supplementation

If dietary fiber intake is insufficient:

• Psyllium fiber supplements (15g daily) can augment dietary fiber intake 1
• However, fiber supplements are not a replacement for a high-quality diet 2

Additional Lifestyle Recommendations to Support Diet

To further reduce the risk of diverticulitis recurrence:

• Achieve or maintain a normal body mass index 2, 1
• Engage in regular vigorous physical activity 2, 1
• Avoid smoking 2, 1
• Limit use of non-aspirin NSAIDs and opioid analgesics 1

Managing Constipation (Common with Diverticular Disease)

• Osmotic laxatives like polyethylene glycol (17g daily) are recommended as first-line treatment 1
• Ensure adequate hydration with water throughout the day
• Regular physical activity helps maintain bowel regularity

Common Pitfalls to Avoid

1. Outdated restrictions: The long-held belief that people with diverticular disease should avoid nuts, seeds, corn, and popcorn has been disproven 4, 5

2. Inadequate fiber transition: Increasing fiber too quickly can cause gas and bloating; gradual increases are recommended

3. Relying solely on supplements: While fiber supplements can help, they should not replace a high-quality diet rich in natural fiber sources 2

4. Ignoring individual triggers: Some patients may find certain foods trigger symptoms despite general recommendations; these should be identified and avoided

By following these evidence-based dietary recommendations, patients with diverticulitis can help manage their condition and reduce the risk of recurrence while maintaining good nutrition and quality of life.