Diverticulitis

By Barbara Gordon, RDN, LD
Diverticulitis

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Diverticulitis is an infection in the gastrointestinal, or GI, tract.

The GI tract extends from the mouth to the anus. Diverticula are small pockets or sacs that can form in the lining of the GI tract. This is a condition called diverticulosis. Most people with diverticulosis are not aware of the condition. They remain free of symptoms for their lifetime.

In a very small number of people with diverticulosis — less than 5 percent — the sacs get infected. This is a condition called diverticulitis. The “itis” part of the name means inflammation. The infection often is due to bacteria or stool collecting in the sacs (diverticula).

Diverticulitis can be very painful. You may feel uncomfortably bloated. Many people with diverticulitis also notice a change in bowel patterns, such as constipation or diarrhea. Diverticulitis may cause fever and elevated white blood cells. If the infection gets worse, small holes may form in the GI tract. You may notice GI bleeding, which presents as blood in your stool.

Causes of Diverticulosis and Diverticulitis

There are many reasons that individuals get diverticulosis and diverticulitis:

  • Genetics. If someone in your family has diverticulosis or diverticulitis, you may be more likely to develop it.
  • Age. The risk of diverticulosis increases with age and over half of people after 60 and older are affected. The risk of diverticulitis also increases with age.
  • Lifestyle factors. Diverticulosis is more common among people with “obese” body mass indices and those who are not physically active. Smoking also increases your risk for this condition.
  • Straining. Straining to pass hard stools stresses the inner lining of the lower GI tract. That stretching can cause diverticulosis.
  • Medicines. Some studies suggest that certain drugs increase your risk of developing diverticula, such as long-term use of aspirin and steroids.

Treatments for Diverticulitis

If you have diverticulitis, you may need medicine to treat the infection. If the infection is very serious, you may have to refrain from eating for a short time. The goal is to give your bowel time to rest and allow internal bleeding to stop.

Long-term, getting enough fiber is key. Fiber helps to bulk up the stool so that it moves more easily through the colon and out of the body. The typical American gets about half of the recommended amount of dietary fiber. So, chances are you are not eating enough high fiber foods such as whole grains, fruits and vegetables. An adequate intake of foods high in fiber will not prevent diverticulosis. It will, however, help to reduce the risk of diverticulitis flare-ups.

How Much Fiber do Adults Need?

Adult women should aim for 25 grams of dietary fiber each day. Men need 38 grams per day.  Don’t worry about counting how many grams of fiber you eat. You can get the right amount of dietary fiber by following a healthy eating style. For example, adults who consume 2,000 calories per day can meet their dietary fiber needs by including the following servings of fruits, vegetables and whole grains:

  • 2 cups of fruit
  • 2½ cups of vegetables
  • 3 ounce-equivalents of whole grains

Also, it is important to slowly add fiber to your diet. One reason is that increasing your fiber intake can also increase gas and potential abdominal bloating and discomfort. By gradually adding higher fiber foods to your daily diet, you can reduce the risk of developing gas.

Plus, adding fiber without increasing your intake of fluids may lead to constipation. To help prevent constipation, set a goal to drink at least 8 cups of fluids per day. Fluid helps your body process fiber without discomfort.

What to Eat to Get the Dietary Fiber You Need

The foods highest in fiber are fruits, vegetables, grains and beans. To get the dietary fiber you need:

  • Eat fruits and vegetables with peels or skins such as apples or pears with the skin and white or sweet potatoes with the skin, just be sure to wash them first.
  • Choose fresh fruit and vegetables instead of juices. Most of the fiber is lost during the juicing process.
  • Try stewed prunes — they’re a great source of dietary fiber.
  • Choose whole-grain breads and cereals. Look for choices with 100-percent whole wheat, whole rye, rolled or whole oats as the first ingredient.
  • Have brown or wild rice instead of white rice.
  • Enjoy a variety of grains. Good choices include whole-grain barley, oatmeal, farro, kamut (Khorasan wheat or Oriental wheat) and quinoa.
  • Bake with whole-wheat flour. You can use it to replace some of the white or all-purpose flour used in your recipes.
  • Enjoy cooked beans more often.
  • Use dried beans and peas when making casseroles or soups.

Read Food Labels

Compare food labels of similar foods to find higher fiber choices. On packaged foods, the amount of dietary fiber per serving is listed on the Nutrition Facts label. Check the Nutrition Facts labels and try to choose products with at least 4 grams of dietary fiber per serving.

Information on dietary fiber is also listed on the Nutrition Facts label as a percent daily value (%DV). The %DV tells you the amount of the fiber in one serving of the food. To select high fiber foods, look for ones that contain at least 20% DV of the recommended daily intake of fiber.

Fiber Supplements

If it is difficult for you to get the fiber you need from the foods you eat, fiber supplements might be helpful. For people with diverticulitis, your health care provider may recommend products containing either methylcellulose or psyllium.

Fiber supplements must be taken with an adequate amount of liquid. Talk with your doctor to find out if fiber supplements are a good option for you.

Foods to Avoid — Generally Speaking, None

In the past, people with diverticulosis or diverticulitis were told to avoid certain foods. We now know that for most people these foods do not appear to irritate the diverticula. So, if you have been restricting the following foods, you may no longer need to avoid them:

  • Popcorn
  • Nuts
  • Sunflower, pumpkin, caraway, poppy and sesame seeds
  • Vegetables with seeds (tomato, zucchini, cucumbers)
  • Fruits with seeds (strawberries, raspberries)

Most people can eat the list of foods above. However, individual reactions vary. Some of these foods might trigger your symptoms. Try to develop awareness about the foods you eat and the symptoms you experience. If a specific food bothers you, limit your intake of that food.

Get Help from a Nutrition Expert

For more information about eating for diverticulitis and diverticulosis, ask your health care provider for a referral to a registered dietitian nutritionist.

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