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Diverticulosis and diverticulitis together are called diverticular disease. Diverticula are small outpouchings in the wall of the colon (large intestine). They’re thought to happen because the colon walls develop weak spots.
The ultimate cause is not well understood, but it is now presumed to be from a combination of lifestyle factors, age, and genetics. Diverticula are common, especially in people over age 50, but they don’t usually cause symptoms. Indeed, many people don’t know they have any until they’re seen during a colonoscopy.
However, if diverticula become inflamed, they can cause diverticulitis, which can be painful and inconvenient. This article will describe the lifestyle changes that may help avoid a diverticulitis flare-up and what to do when one occurs.
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Diverticulitis Diet
Years ago, it was thought that diverticulitis was caused by eating high-fiber foods or foods, such as nuts, seeds, or corn. The theory was that these types of food could get stuck in the diverticula and cause an infection. It’s now understood that eating a high fiber diet may help avoid complications from diverticular disease.
Foods to Eat
Most people don’t have a problem because of their diverticula. Others, however, may develop diverticulitis, which in some cases can be chronic (comes back over and over). In that case, eating high-fiber foods or a modified diet might be part of a prevention plan.
During a flare-up, a healthcare provider might recommend a clear liquid diet for a few days. A liquid diet includes:
- Broth
- Coffee (no milk)
- Plain, clear fruit juices (no pulp)
- Plain gelatin (Jell-O)
- Popsicles (no solid pieces of fruit or pulp)
- Tea
- Water (including ice)
When starting to feel better, and when your healthcare provider says it’s OK, more foods can be added slowly back into the diet. The next step on the way to resuming a regular diet might include foods such as:
- Canned or cooked fruits (remove skin or seeds)
- Canned or cooked vegetables (peel any potatoes)
- Chicken
- Eggs
- Fish
- Fruit and vegetable juices (no pulp)
- Milk products (yogurt and cheese)
- Pasta
- White bread
- White rice
Studies on probiotics (beneficial bacterial cultures) in diverticular disease have had mixed outcomes. It’s not agreed upon if probiotics will or won’t help in recovering from a diverticulitis flare-up. People should ask their healthcare provider about the use of probiotics for diverticulitis.
Foods to Avoid
When the diverticular disease is not causing any symptoms, the focus should be on eating a healthy diet. Increasing fiber and decreasing refined carbohydrates are usually recommended. However, there isn’t a lot of evidence to recommend a specific diet in people with diverticular disease that’s not causing any symptoms.
While dealing with a diverticulitis flare, a liquid diet or a low fiber diet might be recommended. Foods to avoid might contain high fiber content or might irritate the digestive system, such as fried or spicy foods or alcohol.
Foods to be cautious of when there are symptoms of diverticulitis (such as abdominal pain, diarrhea, or rectal bleeding) may include:
- Alcoholic beverages
- Beans
- Fried foods
- Nuts
- Red meat
- Seeds
- Spicy foods
- Popcorn
- Uncooked (raw) fruits and vegetables
- Wheat bread
Check with a healthcare provider about what foods to eat both when there are no symptoms of diverticulitis and when there are symptoms.
Lifestyle Changes
Lifestyle changes may not be able to prevent diverticular disease or diverticulitis. But it’s generally recommended that people make a few changes to their lifestyle to avoid potential complications.
The changes that a healthcare provider might recommend include:
- Avoiding red meat
- Following a high fiber diet
- Getting appropriate exercise
- Maintaining an appropriate weight
- Quitting smoking
Treating Flare-Ups
Diverticulitis might be treated by starting a liquid diet at home for mild symptoms. After two or three days of a liquid diet, the symptoms might begin to feel better. Then it may be recommended to add more foods slowly back into the diet.
If the symptoms are more serious, or if there are complications, antibiotics might be prescribed. The antibiotics might be taken for seven to 10 days.
If symptoms become severe, if there are complications, or if it’s not possible to recover at home, there may be a need for treatment in the hospital. Antibiotics and other medications may be used. Fluids may also be given through an intravenous line (IV).
In rare cases, surgery may be needed to treat diverticulitis. Resection surgery, where a portion of the intestine is removed, is one type of surgery.
Colostomy surgery, which is used to give the bowel a rest, might also be used. In this surgery, the bowel is redirected through the abdominal wall. A colostomy might be reversed, or it could become permanent for serious disease, but this is rare with diverticular disease.
What’s key is to notify a healthcare provider right away when symptoms of diverticulitis begin so it can be treated and avoid it getting any worse or causing complications.
When to See a Healthcare Provider
If symptoms are new, it’s important to talk to a healthcare provider to get recommendations on how to treat them and when it might be necessary to go to the hospital. If the symptoms aren’t getting better in a few days, it’s important to seek treatment so that they don’t get any worse.
If diverticulitis keeps coming back over and over, it’s worth talking to a gastroenterologist (a specialist in conditions affecting the digestive system) about why that might be happening, if there’s anything that can prevent it, or if there is another condition that could be causing problems.
Summary
It might not be possible to avoid a flare-up of diverticular disease, and there’s not much good evidence to guide diet and lifestyle changes. It’s important to get instructions from a healthcare provider about what to do if there are symptoms of diverticulitis. But most people who have diverticula in their colon never have any symptoms.
A Word From Verywell
Diverticular disease is common, especially in Western countries like the United States. As with most health conditions, making choices every day that support health is important in avoiding complications.
It might not always be possible, because not everything that happens with health is under a person’s direct control. But not smoking, eating a high fiber diet, and getting regular exercise are all supportive of avoiding complications from diverticular disease.
