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Diet in Diverticular disease

What is diverticular disease?

The food we eat travels from the stomach through a long tube called the intestine. The last part of that tube is the colon. As we get older, sometimes small pouches, called diverticula, develop in its walls. The resulting condition is called diverticulosis. Many people who have these pouches have no symptoms.

Diverticular disease is defined as clinically significant and symptomatic diverticulosis. Diverticular symptoms include diverticular bleeding, symptomatic uncomplicated diverticular disease, diverticulitis, or segmental colitis associated with diverticulosis. 

What are the risk factors for diverticulosis?

Several lifestyle factors have been associated with diverticular disease.

  • A diet high in total fat and red meat is associated with an increased risk of symptomatic diverticular disease. There is no association between nuts, seeds, corn, and popcorn consumption and the risk of diverticulosis and diverticular bleeding. Dietary fiber and a vegetarian diet are associated with a decreased risk of symptomatic diverticular disease.
  • Obesity and several medications (eg, nonsteroidal anti-inflammatory drugs, steroids, and opiates) are associated with an increased risk of diverticulitis and diverticular bleeding. Statins may be associated with a decreased risk of diverticular perforation. 
  • Current smokers are at increased risk for diverticulitis. However, caffeine and alcohol are not associated with an increased risk for symptomatic diverticular disease.
  • Prevalence increases with age, most commonly at the age of 40 to 60 years old.
  • Vigorous physical activity, such as running and jogging appears to reduce the risk of diverticulitis and diverticular bleeding. 

What is Diverticulitis?

Diverticulitis occurs when the pouches that can develop in our large intestine, called diverticula, have a small tear also known as a “microperforation,” and become infected and cause symptoms. 

Patients may experience abdominal pain (usually left-sided), fever, chills, nausea, vomiting, loss of appetite, and problems with bowel movements.

Do I have to change my diet if I currently have diverticulitis?

Some patients with severe diverticulitis are admitted to the hospital, however, some patients are treated with antibiotics as an outpatient. Your doctor may limit you to a clear liquid diet and re-evaluate you in two to three days. A clear liquid diet includes: 

  • Broth
  • Coffee or tea without milk or cream
  • Fruit juices without pulp, such as grape or apple juice
  • Ice pops without pieces of fruit or fruit pulp
  • Water 
  • Ice chips

As your symptoms improve, you may be able to advance to a soft or regular low fiber diet. A low fiber diet includes:

  • Low-fiber cereals
  • Milk, cheese, and yogurt
  • Fruit and vegetable juice without pulp
  • Canned or cooked fruits without skin or seeds
  • Canned or cooked vegetables such as green beans, carrots and potatoes (without the skin)
  • Eggs, fish and poultry
  • Refined white bread
  • White rice and noodles/pasta

Should I change my diet if I have had diverticulitis in the past?

If you have had diverticulitis, it’s a good idea to eat a lot of fiber. Good sources of fiber include fruits, oats, beans, peas, and green leafy vegetables. If you do not already eat fiber-rich foods, wait until after your symptoms get better to start.

You do not need to avoid seeds, nuts, popcorn, or other similar foods.

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