Download Dietary Guidelines

Diverticular disease
Diverticulosis arises as a result of a build-up of pressure in the large bowel
(colon), which is thought to result from long-term constipation. This pressure
causes weakened areas of the bowel wall to balloon outwards, forming saclike pouches called diverticula.
Sometimes one or more of these pouches become inflamed or infected,
causing severe abdominal pain, fever, nausea and a noticeable change in
your bowel habits. When diverticula become infected, the condition is called
diverticulitis.
Mild cases of diverticulitis can be treated with rest, changes in your diet and
antibiotics. But serious cases of diverticulitis may eventually require surgery
to remove the diseased portion of your colon.
The incidence of diverticulosis increases with age. The cause is not known for
certain, but it is relatively rare in countries where high fibre diets are
consumed. Lack of exercise may also contribute to its development, due to
the more sluggish movements of the bowel contents.
Fortunately, most people with diverticulosis never develop diverticulitis. You
can help prevent both types of diverticular disease by including more highfibre foods in your diet.
The dietary management of diverticular disease
Ensure an adequate dietary fibre intake
It is now recognised that a high-fibre diet promotes soft, bulky stools that
pass more swiftly, require less straining with defecation and result in less
colonic pressure, thereby relieving the symptoms of diverticular disease.
There are however two different types of fibre in the diet – soluble and
insoluble. Soluble fibre is the softer type of fibre that forms a gel. Insoluble
fibre is the harder and more gritty type of fibre.
Soluble fibre-rich foods to plan at each meal include:
o Vegetables, fruit – fresh, frozen, canned and dried
o Oats and oat bran – add 2 tsp to yoghurt and cereal
o Wheat/digestive bran
o Bran-rich cereals, such as bran flakes, Weetbix, Hi-fibre bran,
Whole-wheat Pronutro
o Rye bread, Ryvita
o Digestive biscuits (plain)
o Dried beans, chickpeas, split peas – canned/dried
o Soya mince - add to mince dishes to increase the fibre content
However, insoluble fibre-rich foods should be restricted, as it remains
hard and lumpy throughout the small intestine and colon. This can
cause blockages and further complications with diverticular disease.
Avoid the following insoluble fibre-rich foods, or if you do eat them
chew them thoroughly:
o
o
o
o
o
o
o
Whole-wheat kernels in whole-wheat or whole grain bread
Skins of dried peas, beans and lentils and bean sprouts
Popcorn, sweetcorn and mealies
Raisins and sultanas
Nuts and crunchy peanut butter
Sesame and poppy seeds
Whole grain ‘gritty’ crackers
Over-the-counter fibre supplements may be helpful for people who
cannot or will not eat sufficient amounts of fibre. These productscan
help to keep stools soft and regular but they must be taken with plenty
of fluid.
Fibre should always be added to the diet gradually to help reduce gas
and bloating.
Increase consumption of fluids to at least two litres daily.
Start the day with a large glass of water as you get up in the morning
and drink water with all meals. Limit caffeine intake, which can worsen
symptoms of constipation by causing dehydration.
Plan regular exercise as it helps to stimulate the bowel
movements and reduces pressure inside the colon.
Getting at least 30 minutes of exercise on most days of the week is
recommended.
Consider a daily probiotic supplement. Various probiotic products are
available on the market to supplements the diet. Examples include
Intestiforte, Probiflora and Gastro choice. Activia yoghurt is an example of
a food that contains probiotics known to assist with easing constipation.
Instructions and directions must be carefully followed for maximum
benefit.
Take the time for bowel movements. Set aside sufficient time to allow
for undisturbed visits to the toilet, and don't ignore the urge to have a
bowel movement. Delaying bowel movements leads to harder stools that
require more force to pass and increased pressure within your colon.
For patients with an acute flare-up of diverticulitis, a special low-residue, low
fat diet may need to be prescribed, along with an antibiotic, followed by a
gradual return to a high-fibre diet. Please seek the advice of a registered
dietitian for assistance in this regard.
Meal-planning ideas
Breakfast
A small cup of oats porridge cooked in low fat milk with
added raw oat bran and half a pawpaw with lemon
A cup of bran flakes with low fat milk or yoghurt and a
sliced small banana
A slice of brown toast with a poached or boiled egg, a
grilled tomato and an apple
Smoothie – blend a cup fat free yoghurt or milk with two
fruits and 1 Tbsp smooth peanut butter and oat bran
Snacks
A piece of fresh fruit and a small tub of low fat or fat free
fruit yoghurt
Four Ryvitas with cottage cheese and cucumber or
hummus or peanut butter
A slice of rye toast with anchovy paste
Milo made with low fat or fat free milk
Light meal
A brown bread sandwich filled with tuna in brine/skinless
chicken/lean beef /low fat cottage cheese with salad
vegetables and ½ a small avocado or 5 olives
Two mini pitas filled with egg mayonnaise (boiled eggs
with 1 Tbsp lite mayonnaise)
A bowl of split lentil vegetable soup and grated
mozzarella cheese with a slice of brown toast
A tin sardines on a few rye crackers with a mixed green
salad and ½ a small avocado
Main meal
A small baked sweet potato or a small cup of cooked
brown rice with a palm-sized portion of skinless
chicken/lean beef/pork fillet/fish and vegetables or salad
with ½ a small avocado or 5 olives
Stir-fried vegetables with a palm-sized portion of beef,
pork or chicken strips with 1 Tbsp olive oil and soya
sauce served with a small cup brown rice mixed with split
peas or spaghetti
Two pilchard fish cakes with sweet chilli sauce and 2-3
boiled baby potatoes and steamed vegetables
Mushroom and tomato omelet (2 eggs) served with
roasted vegetables
Optional
dessert
A small piece of fruit with some low fat or fat-free
yoghurt
Note – portion sizes are estimated and serve only as a guide. Contact a
private dietitian for an individualised meal plan and portion guide.