From the Guidelines
A high-fiber diet is recommended for patients with diverticulosis, as it is unlikely to pose a substantial risk and may provide benefits in terms of reducing the risk of recurrent diverticulitis and improving chronic abdominal pain. The American Gastroenterological Association (AGA) suggests a fiber-rich diet or fiber supplementation in patients with a history of acute diverticulitis, although the evidence is of very low quality 1.
Key Components of a High-Fiber Diet
- Aim for 25-35 grams of fiber daily from sources like whole grains, fruits, vegetables, and legumes
- Gradually increase fiber intake to avoid gas and bloating
- Drink at least 8 glasses of water daily to help fiber work effectively
- Include fiber-rich foods such as brown rice, oatmeal, berries, apples, broccoli, carrots, beans, and nuts
- Limit red meat, fatty foods, and processed items that can irritate the digestive system
Additional Considerations
- During symptom flare-ups, temporarily switch to a low-fiber diet until symptoms improve
- Fiber supplements like psyllium (Metamucil) or methylcellulose (Citrucel) can help meet fiber goals if dietary intake is insufficient; start with a low dose and increase gradually
- Regular physical activity also supports digestive health and complements dietary management of diverticulosis
- There is no need to avoid consumption of nuts and popcorn in patients with a history of acute diverticulitis, as the evidence does not support a significant association between these foods and diverticulitis outcomes 1
Evidence Limitations
- The optimal daily dose of fiber necessary to achieve benefit is unknown 1
- The benefit of fiber in patients with recurrent or complicated diverticulitis is also undefined 1
- However, given the potential benefits and low risk of a high-fiber diet, it is still recommended as a dietary approach for patients with diverticulosis.
From the Research
Dietary Recommendations for Diverticulosis
- A high dietary fibre diet is recommended for adults with diverticulosis, as it may help reduce the risk of diverticulitis 2.
- There is no evidence to suggest that a high-fiber diet can prevent diverticulosis, but it may help reduce the development of complicated diverticulitis 3.
- A diet rich in fiber, fruits, and vegetables may be beneficial in reducing the risk of diverticulitis, with fiber from fruits and cereals being particularly beneficial 4.
Food Sources and Diverticulosis
- Consuming whole fruit, such as apples, pears, and prunes, may help reduce the risk of diverticulitis 4.
- There is no association between nut, corn, or popcorn consumption and the development of diverticulosis or diverticulitis 5.
- Higher consumption of red meat, especially unprocessed red meat, may be associated with a mild increase in the risk of acute diverticulitis, while higher consumption of poultry and fish may not be associated with an increased risk 5.