When your stomach and digestive system work well, you probably don’t even think about your digestive health.
If you have issues, though, the symptoms can stop you in your tracks.
Diverticulitis is a type of inflammatory condition in your intestines.
What causes it, and how can you manage it? We’ll fill you in on everything you need to know in this article.
What is diverticulitis?
Diverticulitis is an infection or inflammation of small pouches in your intestines called diverticula. Not everyone has diverticula, but even if you do, they generally aren’t harmful. The only time diverticula become a problem is if they become inflamed and/or infected, as with diverticulitis.
Without experiencing diverticulitis, you likely wouldn’t even be aware that you have diverticulosis. Diverticulosis occurs in around 10% of people over 40 and 50% over 60. The rate of diverticulosis increases as you age, and it affects almost everyone over the age of 80.
Diverticula form when weaker areas of your intestines are subjected to higher pressure and give way, forming pouches. When these pouches become inflamed or tear, diverticulitis occurs. The good news is that less than 5% of people with diverticulosis are estimated to develop diverticulitis.
What are the symptoms of diverticulitis?
If you have a diverticulitis attack, you’ll likely experience one or more of these common symptoms:
- Persistent/constant pain, typically in the lower-left side of your abdomen, which might last for days. The lower left side of the abdomen is the usual site of the pain, but it can also occur in the lower right abdomen.
- Nausea and vomiting
- Abdominal tenderness
- Constipation (more common) or diarrhea (less common)
Getting older is the main risk factor for diverticulosis, which can lead to diverticulitis. Other risk factors for getting diverticulitis include:
- Being a male
- Being overweight
- Eating a low-fiber diet
- Eating a diet high in fat and red meat
- Not exercising
- Taking over-the-counter and prescription pain-killing drugs like aspirin, ibuprofen, naproxen, steroids, or opioids
How does diet affect diverticulitis?
A low-fiber diet has been thought to increase your risk of diverticulosis and diverticulitis. However, research has been conflicting on this theory.
Some studies say that eating a high-fiber diet doesn’t reduce your risk of diverticulosis or diverticulitis, while other studies note a correlation between fiber intake and diverticulitis risk (1, 2).
Regardless of the research, eating a high-fiber diet is still beneficial due to its numerous benefits for your digestive system. Eating a high-fiber diet can help prevent constipation, improve the flora of healthy bacteria, and might reduce your risk of colorectal cancer (3).
Many people are under the false impression that they should avoid nuts, seeds, popcorn, and other high-fiber foods if they have a history of diverticulitis. That isn’t the case – you only need to avoid those foods during an active diverticulitis attack, but not when you’re symptom-free.
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Foods to avoid with diverticulitis
Eating a high-fiber diet is recommended when you don’t have an active case of diverticulitis due to its numerous health benefits. During a diverticulitis attack, you should avoid high-fiber foods because they can irritate the already inflamed pouches in your intestines.
High-fiber foods to avoid during a diverticulitis attack include:
- Beans and lentils
- Whole grains like whole-wheat bread, pasta, etc.
- Fruits and vegetables with skin and seeds, like raspberries, blackberries, apples, etc.
- Wheat bran
- High-fiber cold cereals
- Crunchy peanut butter
You might also want to reduce your fat intake during a diverticulitis flare-up. Fat can worsen stomach upset like nausea and vomiting. In some people, it can cause diarrhea.
Instead of fried and breaded foods, try to choose baked, boiled, or steamed foods. You can also opt for lean protein like skinless chicken instead of a steak dinner and choose lower-fat alternatives until your symptoms improve.
Foods to eat if you have diverticulitis
If you have an active case of inflammation in your gut, it’s best to eat a low-fiber diet to help give you bowel rest. You should only follow a low-fiber diet temporarily since it’s not a healthy diet long-term.
A low-fiber diet (also called a low residue diet) for an active case of diverticulitis might include:
- Refined or enriched white bread and plain crackers, such as saltines/soda crackers
- Cooked cereals like farina, cream of wheat, and grits
- Cold cereals, like puffed rice and corn flakes
- White rice, noodles, and refined pasta
- Well-cooked fresh vegetables or canned vegetables without seeds, e.g., asparagus tips, beets, green beans, carrots, mushrooms, spinach, seedless squash, and pumpkin
- Cooked potatoes without skin
- Tomato sauce
- Ripe bananas
- Soft cantaloupe
- Canned or cooked fruits without seeds or skin, like applesauce or canned pears
- Dairy products (if you’re not intolerant to milk/lactose)
- Margarine, butter, and oils
- Mayonnaise and ketchup
- Sour cream
- Smooth sauces and salad dressing
- Soy sauce
- Seedless jelly, honey, and syrup
- Decaffeinated coffee, tea, and carbonated beverages (if caffeine upsets your stomach)
- Juices made without seeds or pulp, like apple, pulp-free orange, cranberry, etc.
- Strained vegetable juices
Fermented foods contain probiotics that feed the healthy bacteria in your gut. Your beneficial gut bacteria are negatively impacted if you need antibiotics for a diverticulitis flare-up. Eating probiotic-rich fermented foods can help promote the replenishing of healthy gut bacteria.
Some examples of fermented foods include:
- Cultured milk (kefir) and yogurt
Other factors to consider
As mentioned earlier, taking certain medications like NSAIDs (non-steroidal anti-inflammatories) might increase your risk of diverticulitis. Taking NSAIDs can also increase your risk of bleeding from diverticulitis (4).
Smoking increases your risk of diverticulitis and is associated with numerous other health problems like cancer, diabetes, and other preventable chronic diseases. If you currently smoke, here are some helpful resources to help you quit.
Drinking enough fluids is important for your digestive health and can help prevent constipation and other gastrointestinal issues. Constipation can lead to straining, which might increase the pressure in your intestines and lead to more diverticula forming.
Drinking enough water is essential when eating a high-fiber diet since inadequate fluid intake on a high-fiber diet can lead to constipation.
Lifestyle changes to help manage diverticulitis
Gradually increase your fiber intake
After being on a low-fiber diet during the peak of your diverticulitis symptoms, you should work to gradually increase your fiber intake as tolerated.
Diverticulitis is a painful condition, and you don’t want it to lead to an infection. If diverticulitis becomes complicated, it can lead to abscesses and serious infections requiring hospitalization and even surgery. Take it easy and give your body a chance to heal during and after a diverticulitis flare-up.
Be in contact with your healthcare provider
Keep your healthcare provider informed on your symptoms and progress. If things aren’t getting better, early intervention can help reduce the chance of more serious complications.
If you’re admitted to the hospital for more complicated diverticulitis, you’ll likely receive IV fluids and antibiotics and will be monitored until you’re safe to return home.
Being active is good for your digestive health. Regular physical activity can help reduce the pressure in your intestines (high intestinal pressure can lead to diverticula forming).
According to a study, physical activity (specifically running) was inversely correlated with the risk of diverticulitis and diverticular bleeding.
You should rest during an active diverticulitis attack but plan to resume regular physical activity as soon as you are medically cleared to do so.
Diverticulosis is the presence of pouches in the walls of your small and large intestines and is very common among older people. Most people with diverticulosis don’t get diverticulitis, which is inflammation and/or infection of the diverticula (pouches).
Without diverticulitis symptoms, it’s ideal to eat a fiber-rich diet, exercise regularly, not smoke, and stay hydrated. During an active diverticulitis flare-up, you should eat a low-fiber diet to encourage bowel rest and resume a high-fiber diet as soon as you are able.