When your stomach and digestive system works smoothly, you probably don’t even think about your digestive health. It’s easy to take your gastrointestinal well-being for granted. But when trouble arises, the disruptive symptoms can grind your daily routine to a halt.
Enter diverticulitis, a fiery affliction that takes root in your intestines. What ignites this condition, and how can you effectively navigate a diverticulitis flare-up? 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 or infected, as with diverticulitis.
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.
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
Foods to avoid with diverticulitis
While individual diverticulitis flare up symptoms can vary, there are several types of foods that individuals with diverticulitis are often advised to avoid or consume in moderation. Lets take a closer look at foods to avoid if you have diverticulitis and what foods that trigger 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
Alcohol and diverticulitis
A common question is can you drink alcohol with diverticulitis. Indulging in alcohol can potentially irritate your stomach lining and act as a trigger for diverticulitis symptoms. Moreover, regular alcohol consumption might elevate the likelihood of experiencing recurrent flare-ups. Other diverticulitis drinks to avoid include, sugary beverages, such as soda, fruit drinks, sports drinks, energy drinks, and sweetened coffee and tea.
Included in the list of foods to avoid with diverticulitis is fatty foods, so you might 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. In this section, we take a look at the best diet for diverticulitis flare up and what to eat with diverticulitis flare up.
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
How does diet affect a diverticulitis flare up?
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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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 isa important to consider what not to eat with diverticulitis and 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.