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Diverticulitis Diet eBook
This eBook is written with the purpose of presenting all basic information about diverticulitis,
including discussion on other medical conditions that allow diverticulitis to develop.
This eBook has eight chapters, with each chapter focusing on one topic related to diverticulitis. All
chapters contribute to the creation of a complete picture of what diverticulitis is, what causes the
illness, and what treatments / remedies are available to those who are suffering from the disease.
The first two chapters trace the history of diverticulitis from before the 18th century, when the
disease was still unheard of, to the time it was first recorded at the turn of the 20th century, its
epidemiology, up to the time when the disease started to become a common medical condition
among people in the western world.
The third through seventh chapters of this paper deals with the more detailed aspects of the
illness, including: Signs and Symptoms of diverticulitis, Causes of Diverticulitis, Diagnosis of
Diverticulitis, Treatment of Diverticulitis, Complications of Diverticulitis, and Epidemiology of
Diverticulitis.
The eBook ends with the chapter entitled Diverticulitis Diet, an appropriate ending that discusses
how people can avoid and treat the illness though healthy diet and dietary supplements.
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Two details that are emphasized in this paper are the importance of fiber in the diverticulitis diet,
and the importance of seeing a doctor whenever signs and symptoms of the disease start to
manifest themselves.
The information in this document is written for educational purposes only. It is not intended to be a substitute for informed medical advice or
care.
Chapter One - The History of Diverticulitis
Chapter Two - Epidemiology of Diverticulitis
Chapter Three - Signs and Symptoms of Diverticulitis
A Disease That Goes With Aging
Why Pouches Develop On Intestinal Walls
Detecting the Early Signs
More Serious Complications
When it’s Time to go to the Hospital
Chapter Four - An In-Depth Look At the Causes of Diverticulitis
The Risk Factors in Diverticular Diseases
What Happens When Bacteria Is Trapped
Chapter Five - Diagnosis of Diverticulitis
By Way of Elimination
Two Basic Detection Techniques
Chapter Six - Complications of Diverticulitis
Bleeding in the Rectum
Peritonitis, Perforations and Abscess
Abnormal Tissue Connection Called Fistula
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Obstruction in the Intestine
Chapter Seven - Treatment of Diverticulitis
Prevention
Intravenous
Ongoing Treatment/Maintenance
Regular Visits to the Doctor
Surgery
Best Prevention
Chapter Eight - Diverticulitis Diet
Normal, No Flare-up Diet
During Flare-up
Grains
Fruits
Vegetables
Meat and Other Sources of Protein
More about Seeds
Fiber Supplements
Other Types of Diverticulitis Diet Supplements
SEROVERA AMP 500
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The History of Diverticulitis
There used to be a time when diverticulitis was unheard of. The disease was not among the common intestinal problems in the 18 century and
earlier. Curiously enough, when the disease was discovered during the last part of that 18th century, most cases were recorded in North America,
Europe and Australia, where industrialization was rapidly taking place. Until now, diverticulitis is still rare in Africa and Asia.
That the disease started to manifest itself in these advanced countries at a time of frenzied industrialization was not a coincidence.
Industrialization was in fact the link between these countries and diverticulitis.
During the late 18th century, the roller mills were replacing the grist mills all over North America and Europe. The roller mill method of refining
wheat into flour proved to be more efficient than the old grist mill, thus significantly increasing production. This was important in order to cater
to the needs of a growing population.
But the problem with the roller mill was that a significant amount of fiber was removed from the grain during the refining process. As a result,
people started missing fiber in their diet. With less fiber in the body, digestion was compromised and the colon suffered great pressure until it
developed pouches called diverticula in a condition called diverticulosis. Diverticulitis happen when one of these pouches is inflamed.
The same fast-paced industrialization also made way for the refinement of sugar, which was also known to cause diverticulosis. The lack of fiber
in the western diet also happened alongside the popularity of processed foods and increased meat consumption. This increased furthermore the
pressure on the colon.
This explains why diverticulitis is rare in Asia and Africa, where whole grains, fruits and vegetables are the staple diet.
That’s why a diverticulitis diet is always a high-fiber diet. Fiber is needed by the body to make digestion easy. There is fiber in vegetables, fruits
and whole grains. Fiber can turn into a jelly-like substance (soluble fiber) or stay unchanged (insoluble fiber). Either way, fiber softens stools,
making them easy to pass.
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Epidemiology of Diverticulitis
The first cases of diverticulitis were recorded sometime in the late 1800s and early 1900s. The first recorded surgery for diverticulitis was in
1907. Why this disease started to manifest itself in the beginning of the 20th century can be explained by the fact that it was during this time that
the diet of people in the Western World, like America and Europe, changed. The replacement of grist mills by roller mills altered the people’s
diet from that of high-fiber content diet to that of low-fiber content.
This also explains why diverticulitis is rare in Asia and Africa, where the staple diet remains to be filled with fiber, like whole grains, fruits and
vegetables.
The prevalence of diverticulitis depends on age. The prevalence increases from less than five % at 40-years-old, to thirty % when one reaches the
age of 60, to 65 % by the time one reaches 85.
One study conducted on hospital patients in North American showed that admissions for acute diverticulitis increased by 25 % from year 1998 to
year 2005. The study found out that increase was largest in patients who were 18-years-old to 44-years-old, which at 82 %.
The study also found a 29 % increase in elective surgeries for diverticulitis, with the fastest increase, at 75 %, in patients belonging to the 18- to
44-age bracket.
During the illnesses’ early years, those affected by diverticulitis were mostly males. Succeeding studies, however, showed equal distribution, if
not a preponderance on female. The age factor in gender distribution is used to explain this female preponderance or equal distribution of the
disease in later years.
Men below 50-years-old are often the victim of diverticulitis, one study showed. The study showed a slight female preponderance at 70-yearsold and above. On acute diverticulitis among patients under 40-years-old, the study noted the number of male patients as slightly higher.
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Signs and Symptoms of Diverticulitis
One frustrating characteristic of diverticulosis, the origin of diverticulitis, is that you cannot tell the early symptoms unless you undergo some
tests and the doctor detects the problem. Only the doctor can confirm if it is diverticulitis you’re having because the disease shares the same
symptoms with those of other medical conditions affecting the intestines and the nearby areas.
Some people only came to learn they have the disease when it was detected while they were being tested for other issues. This means that you
might feel healthy about yourself, but in reality you might silently be suffering from conditions like diverticulosis.
Learning about how diverticulitis develops will help you detect the early warning signs of the problem so you can consult the doctor right away,
before the matter develops into an irreversible condition. It also helps if you and your family develop the habit of having a general medical
check-up at least once a year.
Researching on the condition in the Internet or other sources will also teach you how to protect yourself from the disease, including how to have
a high-fiber diverticulitis diet.
A Disease That Goes With Aging
Diverticulitis is a condition affecting the colon, which is that part of the large intestine running from the cecum to the rectum. As the body ages,
the large intestinal walls weaken. When this happens, sacs, or pouches, start to form on the intestinal walls. These sacs are called diverticula,
and the entire condition is called diverticulosis. It’s when the diverticula, or the pouches, become infected and inflamed that diverticulitis
happen.
Because the symptoms of diverticulosis are oftentimes undetected, one will not know if this has developed into diverticulitis, and the severe
pain that comes with sudden diverticulitis attack can be a shock.
Why Pouches Develop On Intestinal Walls
Medical studies vary in their findings as to why the pouches develop infection. But they surmised that infection could be caused by stool or
bacteria that got stuck in the pouches. As bacteria rest on the diverticula, they slowly eat into the intestinal walls,
If you have experienced how appendicitis feels, the pain caused by diverticulitis is similar. But while the pain in appendicitis is usually in
abdomen’s lower right side, the pain of diverticulitis is felt in the lower left side.
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Diverticulitis oftentimes attacks without warning and the pain can be severe. In some cases, though, the attack starts with initial manifestation
of mild pain that suddenly shoots up to as an intense, excruciating pain. Over several days, the pain gets even worse, although fluctuating in
intensity.
Detecting the Early Signs
Most common signs of diverticulitis are fever, diarrhea or constipation, abdominal tenderness, nausea and fever. Other more serious signs and
symptoms of the disease include rectal bleeding, bloating, abdominal tenderness, like when bending over or wearing a belt, vomiting, frequent
urination and difficulty in urination.
Of all people having diverticulosis, 20 % will have the symptoms associated with the condition. When the condition deteriorates into
diverticulitis, complications develop, resulting in colon bleeding, abscess filled with pus, colon rupturing and obstruction in colon. These
complications are often accompanied by vomiting and nausea.
More Serious Complications
When the condition worsens into diverticulitis, more serious complications arise. The area around the inflamed diverticula, the bulging sacs or
pouches, collects pus, leading to the formation of abscess occurring usually in the pelvis. The colon gets ruptured, causing the abdominal cavity
to get infected. This infection is called peritonitis, which is life-threatening. There is also bleeding within the colon. All these complications are
accompanied by nausea and vomiting.
In some cases, the inflamed diverticula leads to erosion into the urinary bladder, infecting it in the process. Stool may also erode into a blood
vessel found in the diverticulum’s lower part, which results in bleeding. Blood clots passing through the rectum may not involve abdominal pain,
but it doesn’t mean it is not something to worry about. The blood clots are usually maroon, red or dark red. In rare cases, the blood clot may be
black if the colon is bleeding.
When it’s Time to go to the Hospital
The bleeding caused by diverticulitis may last up to several days, and even weeks, and can be continuous or intermittent. Bleeding is a sign that
those having the symptom should better be taken to the hospital, where his condition can be monitored more closely.
If the blood loss is moderate to severe, blood transfusions are administered. In some rare occasions, blood pressure drops due to accelerated
bleeding. This will cause the patient to experience dizziness and shock, and a loss of consciousness. Some bleedings refuse to stop and are
severe. In these cases, the diverticula that are bleeding are removed in a surgery.
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Most recorded cases, however, show that bleeding stops spontaneously, and after a few days’ stay in the hospital, the patient can go home.
An In-Depth Look at the Causes of Diverticulitis
The Risk Factors in Diverticular Diseases
Age is another factor in diverticulosis. The condition has been observed to develop when a person is in his 40s, with the risk factor increasing as
the person gets older. This is because the muscles in the large intestine start to weaken at this age. The figure is that ten percent of people in
their 40s are at risk, while the number is 60 percent in people 80 years old and above.
Aside from age, the other contributing factor for diverticulosis are recurring constipation, disorders in the connective tissue affecting the wall of
the colon, too much red meat in the diet, high fat content in the diet and, as mentioned earlier, lack of fiber in the diet.
Of all people with diverticulosis, ten to twenty percent will develop diverticulitis, with the number increasing as the person grows older.
What Happens When Bacteria is Trapped
The question now is: what causes the diverticula to be infected, leading to diverticulitis? This question continues to the subject of medical
research. But it is commonly believed that infection happens when bacteria in the body’s waste material or stool get stuck in the diverticula.
Doctors in the past used to believe diverticulitis was caused by popcorn, seeds and nuts that were stuck in the diverticula. This theory has long
been dismissed as false. Medical research has not found any connection between these foods and diverticulitis. As far as food is concerned, the
lack of fiber in the diet is the most accepted cause of diverticular diseases.
Diagnosis of Diverticulitis
Early diagnosis of a diverticular disease is important to fight the condition through a healthy lifestyle and diverticulitis diet. By themselves, the
pouches protruding from the colon walls, also known as diverticula, do not pose problems. People who have diverticulosis learn about their
condition while they are undergoing laboratory tests for colorectal cancer or for other intestinal conditions.
Problems only occur when the diverticula are inflamed. But when this happens, the person with diverticulitis will only be diagnosed with it when
he’s experiencing an acute attack.
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What makes diagnosis of diverticulitis tricky is that its symptoms are similar to those of other intestinal diseases. What the doctor does is
conduct tests that will rule out other problems that cause your pain. By way of elimination, the doctor arrives at a conclusion that you’re
suffering from diverticulitis or from something else.
By Way Of Elimination
To diagnose diverticulitis, laboratory tests must be able to eliminate the following diseases: inflammation of the pelvis, appendicitis, irritable
bowel syndrome, ectopic pregnancy, cancer of the ovary, cancer of the colon, stomach ulcers, ischemic colitis and inflammation of the bowel.
The doctor will also check if the degree of tenderness of your abdomen, signs of infection in your white blood cells and order a CT scan test to
take a look at your inflamed diverticula.
Two Basic Detection Techniques
A technique called colonoscopy is used to look into your large intestine to verify the presence of diverticula, the protruding pouches in the colon.
In this technique, a coloscope, a thin tube equipped with a microscopic camera at the tip, is inserted in the rectum to reach the colon.
Barium enema X-ray is another technique used to confirm the presence of protruding pouches in the colon. The colon is an organ that is not
detected by an X-ray, unless barium, a form of liquid, is used to rub on the interior surface of the colon.
In both colonoscopy and barium enema X-ray, you will take a laxative to remove your bowels before the procedures can start.
Complications of Diverticulitis
Although the percentage of cases diverticulitis resulting in complications is not high, the condition is not something to be taken lightly. If left
unchecked, diverticulitis can lead to complications, some so serious they become life-threatening.
Diverticulitis can result in blockages of the colon, infections, bleeding, and perforations, or small tears. Each of these complications will be
discussed here.
Bleeding in the Rectum
Rectal bleeding is a rare diverticulitis complication. Doctors agree that rectal bleeding is a result of blood vessels in the diverticula weakening
and then bursting. A person having this condition will find blood in his stool. The bleeding may be mild or severe. However, the bleeding may
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stop on its own without requiring any treatment. But this should not be taken to mean that all is well now because the bleeding has stopped by
itself.
Even if the bleeding comes in small amount, and even if it stops on its own without medication, the affected person must see a doctor right
away. In most cases, the patient undergoes colonoscopy, a procedure used to locate the origin of the bleeding and stop it. Other times, a dye is
injected into an artery in a procedure called angiography. Surgery is recommended if the bleeding refuses to stop.
Peritonitis, Perforations and Abscess
A diverticulitis infection oftentimes heals within a few days’ of antibiotic treatment. But in some cases, the infection worsens and leads to the
formation of abscess in the walls of the large intestine or colon.
An abscess is pus that gathers in one specific area. This causes swelling and the destruction of tissues. Some abscess are small and don’t spread
from the wall of the intestine. They are cleared out using antibiotic treatment. Other cases refused to heal with antibiotics. Doctors deal with
this using a small tube or catheter that is passed through the skin to reach the abscess. The patient is numbed. Then a needle is inserted in the
skin through the tube until it reaches the abscess. Then the fluid is drained out through the tube or catheter. X-ray, or sonography, usually
guides this procedure.
Diverticulitis also leads to perforations, which sometimes issues pus from the inflamed diverticula, resulting in peritonitis. In peritonitis, a large
abscess in the abdominal cavity is formed. A person affected by this condition will experience nausea, severe tenderness in the abdomen and
vomiting. Peritonitis requires surgery immediately after it is discovered to remove the part of the intestine that is damaged. Peritonitis can be
fatal if not dealt with immediately.
Abnormal Tissue Connection Called Fistula
Fistula is an abnormal attachment between the tissues of two different organs, like the intestine and bladder, or between the abdominal wall
and the intestine, or between a skin and an organ. During infection, these tissues come in contact with each other and stick together. A fistula is
formed when the damaged tissues heal together while they are still attached to each other. The organs involved in this condition are usually the
small intestine, the colon, the skin and the bladder.
The fistula that develops between the colon and the bladder is the most common. This condition also causes the urinary tract to be infected
severely for a long time. A fistula and the portion of the colon surrounding the infection are removed through surgery.
Obstruction in the Intestine
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Diverticulitis also causes scarring, which could lead to a total or partial intestinal blockage. A diverticulitis diet may aid digestion and the passing
of stool, but in this case, an urgent and immediate solution is needed. This condition prevents the colon from doing its job, which is moving
bowel contents, because the intestine is blocked. A complete blockage of the intestine requires surgery. There’s no immediate surgery needed if
the blockage is partial.
Treatment of Diverticulitis
Like any disease, treatment of diverticulitis depends on the extent of damage it caused to the affected part. There are several types of treatment
for diverticulitis, ranging from prevention to surgery. This article attempts to discuss these types to guide people on what to do in case they feel
they have the illness.
1. Prevention
The symptoms of diverticulitis dictate how the disease is treated. If the symptoms are mild, and signs of complications are not present,
treatment includes oral pain relievers and antibiotic and a liquid diet.
A change of diet will also be recommended. A diverticulitis diet is full of fiber to aid digestion, soften stool and minimize pressure on the walls of
the colon or large intestine. As prevention is the best treatment, a diverticulitis diet prevents the formation of diverticula, which when inflamed
or infected causes diverticulitis.
The treatment is the same for brief, intermittent and chronic bouts of diverticulitis. It is only when complications occur that diverticulitis requires
a more serious treatment. For severe pain, liquid diet, oral pain relievers and antibiotic may not be enough. Your safest option is to go the
hospital.
2. Intravenous
If the treatment involves the intravenous (IV) approach, hospitalization is normally required to allow doctors more time to examine the patient’s
condition more closely. The patient is not allowed to food and drink through the mouth for at least a week to gives the bowel a much-needed
rest.
During the intravenous treatment, the patient’s stomach is emptied. The stomach’s contents are sucked out using a tube that passes through
the nose, down the throat and into the stomach. This procedure is called nasogastric or NG tube, and is recommended for patients who are
experiencing swelling in the abdomen and are vomiting.
If diverticulitis is treated promptly, the condition improves within two to three days, and the patient may be discharged from the hospital.
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3. Ongoing Treatment/Maintenance
After the patient has been discharged from the hospital, the doctor may prescribe a continuous dosage of antibiotic. The patient must take the
prescription and finish the dosage even if he is not feeling sick anymore. This is an ongoing treatment to prevent the symptoms from recurring
and another attack from happening.
Aside from the take-home antibiotic prescription, the patient may also be asked to start a diverticulitis diet, which contains high amount of fiber.
This diet is usually composed of fruits, wheat, vegetables and bran.
If it is difficult for you to have these high-fiber foods all the time, the doctor will advise you to take fiber supplements. These supplements may
come in tablet, capsule or liquid form. You will also have to get more fluids, like water, fresh milk and vegetable or fruit juice, every day.
4. Regular Visits to the Doctor
Being out of the hospital doesn’t mean you are no longer seeing your doctor. You will have to see your doctor two days after your out-patient
treatment started to check the progress of your medication.
Six weeks after you left the hospital, the doctor will order a barium enema X-ray or colonoscopy even if the symptoms have been put under
control. This is to make sure there are no more problems, like inflammation of the bowel, or worse, cancer of the colon.
If all goes well, your visits to the doctor will lessen in frequency until you will are advised to make the visit only when you feel the symptoms
coming back. Because of your diverticulitis history, your lifestyle and your diet will have to change forever.
5. Surgery
In cases where complications occur, such as obstruction to the bowel, perforation, and abscess, surgery is advised to remove the part of the
intestine that is affected.
Surgical procedures for diverticulitis involve the removal of the affected part of the large intestine. This is called partial colectomy. After the
affected part is removed, the remaining parts are reconnected. In some severe cases, several surgeries are required to treat the problem.
In between surgeries, the patient undergoes colostomy. In colostomy, the doctor cuts an opening in the patient’s abdomen. Then the doctor will
attached the upper part of the intestine to the abdominal opening. The body’s waste passes through this hole and into a disposable bag. After
the treatment of diverticulitis, the opening in the abdomen is closed and the intestine reconnected.
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The doctor may recommend surgery if the patient suffers repeated diverticulitis attacks. Two or three repeated severe attacks will be enough
grounds to go for surgery. Surgery may also be recommended for people whose chances of having repeated attacks are high. These are mostly
people 40-years-old or younger or whose immune system is impaired.
Surgery is also recommended for people who have abdominal cavities between the colon or large intestine and a neighboring organ, usually
uterus, vagina or the bladder. Diverticulitis surgery is also performed if the infected pouch has burst into the cavities.
Other conditions where surgery may be recommended include the following: peritonitis (an infection that has affected the abdominal cavity,
obstruction of bowel and narrowing of a spot in the colon, or stricture, infection of the blood (sepsis), and a recurring problem on bleeding that
other treatments have failed to stop.
The figures, however, are encouraging to many people with diverticulitis. Of every 100 cases of diverticulitis, only six require surgery.
6. The Best Prevention
Maintaining a healthy lifestyle and keeping a high-fiber diet will always be the best defense against diverticular diseases. Regular exercise will
also help, while a visit to the doctor once in a while keep you posted about what’s going on inside your body. How to prevent diverticulitis
through proper diet will be discussed in the following chapters of this paper.
Diverticulitis Diet
Normal, No Flare-up
It has been mentioned several times in this report that a high-fiber diet helps prevent and heal diverticulosis and its resulting condition,
diverticulitis. But while this true, one suffering from diverticular diseases must not decide on a diverticulitis on his own without consulting a
doctor. A diverticulitis diet or any health diet for that matter, works best if this has the approval of the doctor who will guide the patient until the
medical condition is eliminated.
When one is experiencing diverticulitis attacks, doctors will recommend a low-residue diet. A liquid diet is also an alternative. This is aimed at
decreasing bowel volume to give the colon a rest and to give time for the inflammation to subside and the infection to heal. A low residue
diverticulitis diet involves a daily intake of at least ten grams of fiber.
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High-Fiber Diet
A high-fiber diverticulitis diet usually contains the following:
Grains
Grains and grain products include buns, white bread that is refined and enriched, bagels, English muffins and plain cereals such as cornflakes,
Rice Krispies®, soda crackers, arrowroot cookies, plain melba toast, refined noodles or past, and white rice.
Fruits
Fruits and fruit products are an excellent source of fiber. The list includes: applesauce, banana, canned fruit cocktail, honeydew melon, fruit
juices but not including prune juice, watermelon and peaches.
Vegetables
One will never go wrong with vegetables, especially people suffering from almost any form of medical condition. But some vegetables are
especially recommended for patients of diverticulitis. The list includes vegetable juices, alfalfa, beets, sprouts, red and green peppers, lettuce,
beets, yellow and green beans, cucumber, celery, eggplant, peeled potatoes, zucchini, carrots, and squash.
A diverticulitis diet must avoid vegetables belonging to the cruciferous family, like cauliflower, cabbage, Swiss chard, Brussels sprouts, kale and
cabbage.
Meat and Other Sources of Protein
Not all protein sources are harmful to people with diverticulitis. The following may be included in the diet: eggs, fish, tender and well-cooked
meat. Traditional measures against diverticulitis say that nuts and seeds must be avoided. More on this later.
With or without diverticulosis or diverticulitis to worry about, a general diet that contributes to a healthy digestive system must contain fiber.
According to the Institute of Medicine, people under the age of 50 years old must have a fiber intake of 25-38 grams a day. For people older than
50, the Institute of Medicine suggests a daily consumption of 21-30 grams of fiber.
With the right amount of fiber, the size and weight of one’s stool is increased. Fiber also softens the stool. Stool that is soft and has the right size
and weight is easier to pass. A smooth bowel does not put pressure on the intestine, minimizing the chances of diverticulosis and diverticulitis.
More about Seeds
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It is commonly believed that people with diverticulitis should avoid eating seeds, nuts, and grains that are small, as these tiny particles might get
trapped or lodged in the diverticula, or pouches, resulting to infections. In fact, a lot of doctors still warn their patients against these foods.
Included here are foods with small seeds, like strawberries or tomatoes, popcorn hulls, pumpkin, sunflower, sesame seeds and caraway.
Whether they do it out of conviction or they just want to be on the safe is not clear.
Recent studies, however, would say that seeds and nuts and similar foods don’t cause any problem and are generally harmless. The studies are
conflicting, and until now, doctors continue to be divided on the role of seeds and nuts in the diverticulitis diet.
With no definitive position agreed upon by doctors, people with diverticulitis take it upon themselves to be on the safe side and avoid seeds and
nuts completely.
During Flare-up
Low-Fiber Diet
It has been established by medical research that a low-fiber diet is the main cause of diverticulosis, the condition that paves the way for
diverticulitis. In fact, a diverticulitis diet is mainly composed of high-fiber foods.
In diverticulosis, the colon in the large intestines develops small sacs or pouches that bulges outward. These pouches are called diverticula. To
illustrate this condition more graphically, picture a sausage poking out from a sausage casing that’s broken. Understanding diverticulosis is key in
understanding diverticulitis more fully.
The storage of waste materials in the body and their subsequent elimination are the main functions of the large intestine. Fiber softens the
waste, or stool, and makes it easier to pass. Without fiber diet to aid digestion, the waste materials subject the muscles of the colon to pressure,
leading to the formation of the bulging pouches, or diverticula, particularly in the weak spots of the colon. Infected diverticula result in
diverticulitis.
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FOOD GROUP
MILK
MEAT, FISH, POULTRY,
EGGS, CHEESE, MEAT
ALTERNATES
BREADS & CEREALS
POTATO & STARCHES
VEGETABLES
FRUITS
FATS
SWEETS & DESSERTS
BEVERAGES
SOUPS
MISCELLANEOUS
FOODS TO INCLUDE
FOODS TO AVOID
Fat free, reduced fat, whole milk; Lactaid milk;
Buttermilk, yogurt without restricted fruit and nuts;
non-fat dry milk solids (reconstituted), milkshakes
Tender, lean, beef, lamb, liver, poultry, veal, pork, ham
(if tolerated); smooth peanut butter; fish; cottage cheese, mild
flavored cheeses; eggs; tofu.
Bread made with refined flour; melba toast; refined
hot cereals including instant oatmeal, farina, and
grits; dry refined cereals including puffed rice, cornflakes, rice
Krispies, special k ; refined crackers such as saltines; rice
cakes; bagels; pancakes, waffles; tortillas made from refined
white flour.
White or sweet potato prepared without skin or frying; white
rice; refined brown rice; spaghetti; noodles; macaroni; pasta;
couscous.
Strained vegetable juice; well cooked fresh or canned
vegetables such as asparagus tips, beets, green beans,
carrots, acorn squash without seeds, pureed spinach, and
tomato sauce; lettuce if tolerated.
Strained fruit juice; citrus fruit sections without membrane;
stewed or canned fruit without skin or seeds; ripe banana;
soft cantaloupe or honey dew melon.
Margarine, oils, butter, cream, shortening, sour cream,
mayonnaise, cream cheese
Hard candy, jelly, honey, syrup; refined cakes, pies,
doughnuts; cookies; pudding; sherbet; custard; ice cream;
gelatin with allowed fruit; chocolate in small amounts.
Tea, coffee, decaffeinated coffee, carbonated beverages,
fruit beverages, allowed vegetables, noodles, rice or refined
flour
Bouillon, broth, or creamed soups made with allowed
vegetables, noodles, rice or refined flour
If you have an intolerance to lactose you may need
to limit dairy to small portions with meals and/or use
lactose reduced products.
Fried meats, sausage, spicy cold cuts, frankfurters;
crunchy peanut butter; excessive cheese products;
fried eggs; dried beans.
Salt and mild seasonings as tolerated; finely ground pepper;
cocoa powder.
Bread made with bran, seeds, coarse whole wheat
or cracked wheat; whole grain cereals such as
shredded wheat, bran flakes, granola; raw bran; old
fashion oatmeal; whole grain crackers; graham crackers;
buckwheat pancakes; bulgar.
Potato skins, fried potatoes, potato chips; coarse grain
brown and wild rice; whole grain pasta.
Raw or partially cooked (steamed) vegetables; vegetables
with seeds; sauerkraut; dried beans; cooked peas; winter
squash; broccoli; Brussels sprouts; cabbage; onions;
cauliflower; baked beans; and corn
All raw fruits (except banana) ; dried fruits and raisins;
prunes (fresh or stewed); unstrained fruit juice, canned
pineapple, fresh and frozen berries.
Do not consume excess amounts, especially saturated fat,
for overall health
Those made with nuts, coconut, seeds, skins; jams,
marmalades and preserves; fried pastries (no doughnuts).
Alcohol
Highly seasoned soups, bean soups
Whole seed spices and herbs; popcorn; whole grain
snacks; nuts; seeds; strong flavored spices or herbs
not tolerated; olives, pickles
Diverticulitis Diet from SEROVERA®
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Dining Out (the low fiber way)
Your low fiber diet guidelines can easily be followed when dining out. Read the menu carefully and ask questions about how foods are prepared
and what accompaniments are served with the various items you are considering. Request that any foods you need to avoid be eliminated from
your plate; they are easier to resist if they're not there.
Suggestions
Appetizers: Fruit Juice, shrimp with lemon wedge, consommé
Main Entrée: Lots of options here, just stay away from fried foods, spicy sauces, and highly seasoned foods. Try broiled fish, grilled
chicken breast, or veal in a light mushroom sauce
Vegetables: Stick with the ones you know you can tolerate; avoid heavy, spicy sauces
Starches: Skinless baked potato with sour cream, white rice, pasta
Desserts: Angel food cake, gelatin, frozen yogurt, ice cream, sorbet, plain cake
Important Facts to Know
Eating a low-fiber diet will limit your bowel movements and help ease diarrhea or other symptoms of abdominal conditions, such as
abdominal pain. Once your digestive system has returned to normal, you can slowly reintroduce fiber into your diet.
If you have diverticulitis, it is important to include adequate fiber & fluids in your diet to prevent constipation.
Fiber should only be avoided during the acute phase of this disease (diverticulitis)
Your physician or dietitian will help you determine the appropriate diet to follow.
Be careful to increase your fiber intake gradually and drink plenty of fluids. Consult with a dietitian to help you make this transition.
You will need to continue to avoid seeds, nuts, popcorn, and corn; however, there is no scientific evidence that supports that these
foods cause diverticulitis.
The goal of medical nutrition therapy for the treatment of diverticulosis is to manage the disease. It is not intended to cure or
prevent the disease.
Risks
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If you don't follow the low-fiber diet as prescribed by your doctor, you risk irritating or obstructing your digestive tract. Once the inflammation
and infection are eliminated, the patient is advised to return gradually to a high-fiber diet. This is to normalize once again the flow of food
through the intestines and to prevent constipation. If there’s limited source of fiber in the patient’s diet at this point, the doctor may
recommend a daily fiber health supplement.
Fiber Supplements
The inaccessibility of fiber in some areas makes it necessary to take fiber supplements. It is important, however, for one to discuss with his
doctor what fiber supplement is best for him and what dosage. Other supplements may cause allergies to some diverticulitis patients, or an
adverse chemical reaction when they come in contact with the patient’s medication.
Two types of dietary supplements for people with diverticulitis are Psyllium and Glucomannan.
Psyllium, which belongs to the plantain family, works as a laxative and is effective against intestinal conditions, like constipation and diarrhea.
The plant from which this supplement comes from grows in many parts of the world, making it easily available. Psyllium also lowers cholesterol
level. A high-fiber diet supplemented by psyllium is said to be very effective remedy for diverticulitis, especially after an attack or bout.
Glucomannan, on the other hand, dietary supplement that is soluble in water and reduces the chances of diverticulitis attacks. Glucomannan is
popular in East Asia for centuries now. As stated earlier in this paper, diverticulitis is a rare disease in Asia. This could be one of the explanations.
Other Types of Diverticulitis Diet Supplements
The multi-purpose omega-3 fatty acid from fish oil helps in reducing inflammation of the diverticula and preventing colon cancer. It is important,
however, to consult the doctor if you are taking medication for blood-thinning before you take omega-3 supplements.
Another supplement for a diverticulitis diet is glutamine, an amino acid that assists the intestines in their work. Glutamine is not a cure for
diverticulitis, but it sets a healthy intestinal atmosphere that makes it difficult for diverticula inflammation to happen.
Vitamin B-complex, and Vitamins A, C and E should also be a part of a diverticulitis diet.
While there are various proofs of the efficiency of these dietary supplements against diverticulitis, one should not take them without a doctor’s
approval.
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