From the Guidelines
During a diverticulitis flare, a clear liquid diet is advised during the acute phase to rest the digestive system and improve patient comfort, as recommended by the American Gastroenterological Association in 2021 1. This approach is based on the idea that diverticulitis can cause mechanical obstruction and/or systemic inflammation, and a clear liquid diet can help reduce these effects. Some key points to consider during this phase include:
- Consuming clear liquids such as broths, clear juices without pulp, gelatin, and water
- Avoiding solid foods
- Staying well-hydrated by drinking at least 8-10 cups of fluid daily As symptoms improve, the diet can be advanced to a low-fiber diet, and eventually, fiber can be reintroduced to prevent future flares, with the goal of consuming 25-35 grams of fiber daily from fruits, vegetables, and whole grains 1. It's also important to note that a high-quality diet, maintaining a normal body mass index, being physically active, not smoking, and avoiding nonsteroidal anti-inflammatory drugs can help reduce the risk of recurrence 1. However, the evidence for specific dietary recommendations is not always strong, and patient preferences and side effects should be considered when counseling a patient 1. Overall, the goal of the dietary approach is to reduce mechanical irritation to the inflamed diverticula, allow the colon to heal, and prevent constipation that can trigger future episodes. Key foods to avoid during the acute phase and initial recovery include:
- Nuts
- Seeds
- Popcorn
- Raw vegetables
- High-fiber fruits
- Solid foods during the initial clear liquid diet phase It's essential to follow the guidance of a healthcare provider to determine the best course of treatment and dietary approach for individual cases of diverticulitis.
From the Research
Diverticulitis Flare Diet
- A liquid diet is often recommended for patients with uncomplicated acute diverticulitis, as seen in studies 2, 3.
- The diet typically consists of clear liquids for the first 2 days, followed by a gradual introduction of solid foods 3.
- Pain control with oral acetaminophen is also recommended to help manage symptoms 2, 3.
- Antibiotics, such as metronidazole and ciprofloxacin, are commonly prescribed to treat diverticulitis, but the effectiveness of antibiotics for uncomplicated diverticulitis is still uncertain 4, 5, 6.
- Some studies suggest that antibiotics may not be necessary for uncomplicated diverticulitis, and that a liquid diet and pain management may be sufficient 6.
- However, more research is needed to determine the best course of treatment for diverticulitis, including the role of antibiotics and diet 6.
Key Findings
- Outpatient treatment of uncomplicated acute diverticulitis with oral antibiotics and a liquid diet has been shown to be safe and effective 2, 3.
- The use of antibiotics for uncomplicated diverticulitis is still a topic of debate, with some studies suggesting that they may not be necessary 6.
- A clear liquid diet for the first 2 days, followed by a gradual introduction of solid foods, is often recommended for patients with diverticulitis 3.
- Pain control with oral acetaminophen is also an important part of managing symptoms 2, 3.