Diverticulitis is a common digestive disease characterized by inflamed pouches called diverticula that form in the wall of the colon. Certain foods can aggravate the condition by lodging in diverticula and causing infection and inflammation. Knowing which foods to avoid during a diverticulitis flare-up is key to managing symptoms and preventing complications.
What is Diverticulitis?
Diverticulitis occurs when diverticula in the colon become infected or inflamed. Diverticula are small, bulging pouches that can form when pressure builds up in the colon. This pressure weakens spots along the colon wall, allowing pouches to form and push outward.
It’s estimated that more than half of all people over age 60 have diverticula in their colons. However, only about 20% of people with diverticula get diverticulitis. Diverticulitis can range in severity from mild to life threatening.
Common symptoms of a diverticulitis flare-up include:
- Abdominal pain, usually in the lower left quadrant
- Fever
- Nausea
- Vomiting
- Bloating
- Constipation or diarrhea
A diet high in processed foods and low in fiber is thought to contribute to diverticula formation. Obesity and smoking may also increase risk. Diverticulitis is more common as people age, with the average age of diagnosis being 60.
Trigger Foods to Avoid with Diverticulitis
During a flare-up, a low fiber diet is recommended to give the colon time to heal. High fiber foods can exacerbate symptoms by lodging in diverticula. However, once symptoms improve, a high fiber diet is important for preventing future episodes.
Here are some of the main foods to avoid during acute diverticulitis:
Seeds and Nuts
Seeds and nuts are some of the biggest culprits for aggravating diverticulitis. Small hard pieces can lodge in diverticula, causing infection, blockages, perforations, and abscesses.
Foods to avoid include:
- All seeds like sesame, poppy, caraway, sunflower
- All nuts including peanuts, almonds, cashews, walnuts, pecans
- Foods that may contain seeds or nuts like baked goods, granola, muesli
Whole Grains
High fiber whole grains, such as whole wheat or multigrain, can be problematic during a flare-up. The fibrous bran can cause irritation. Refined grains are easier to digest until diverticulitis symptoms improve.
Avoid foods like:
- Whole wheat or multigrain bread
- Whole grain pasta
- Brown rice
- Popcorn
- Whole grain cereals
Certain Fruits and Vegetables
While fruits and vegetables are an important part of a high fiber diet for preventing diverticulitis, some types are higher in insoluble fiber, which can worsen symptoms during a flare-up. Soluble fiber that dissolves in water is gentler.
Fruits and veggies to avoid include:
- Corn
- Broccoli
- Cabbage
- Cauliflower
- Asparagus
- Brussels sprouts
- Beans
- Lentils
- Berries with seeds like strawberries, raspberries
Certain Meats and Proteins
Fatty or tough cuts of meat can aggravate diverticulitis. Nuts and seeds mixed into some protein foods should also be avoided.
Problematic protein foods include:
- Tough cuts of red meat with gristle
- Sausage with seeds like mustard or fennel
- Meat substitutes with veggies, nuts or seeds
Dairy
Milk, ice cream, and other dairy foods are high in fat and may worsen diverticulitis symptoms. Lower fat dairy options are better tolerated.
Limit intake of:
- Whole milk
- Full fat cheese
- Sour cream
- Butter
- Ice cream
Oils and Spreads
High fat oils and butters can exacerbate inflammation and irritation. Limit added fats during flare-ups.
Avoid:
- Olive oil
- Coconut oil
- Avocado oil
- Butter
- Margarine
- Mayonnaise
Spicy Foods
Heavily spiced or seasoned foods can irritate the colon. It’s best to avoid anything too hot, salty, or acidic.
Say no to:
- Hot sauce
- Chili powder
- Black pepper
- Barbeque sauce
- Citrus fruits and juices
- Pickled foods
- Spicy sauces like mustard, horseradish, curry
Alcohol
Alcohol consumption is associated with diverticulitis attacks. All alcohol should be avoided during symptom flare-ups.
Popcorn, Chips, and Crunchy Snacks
Hard, crunchy snack foods often get stuck in diverticula. Stick to soft, easy to digest snacks when possible.
Say no to:
- Popcorn
- Potato chips
- Crackers
- Pretzels
- Nuts
Foods to Eat During a Flare-Up
While certain foods should be limited or avoided during acute diverticulitis, others can help ease symptoms and promote healing. Here are some of the best foods to focus on during a flare-up:
Clear Liquids
Hydration is important when you have diverticulitis. Clear liquids like water, broth, and juices are easy to digest. Sports drinks can help replenish lost electrolytes.
Low Fiber Fruits and Vegetables
Fruits and veggies with lower fiber and smaller seeds can provide important vitamins and minerals without irritating the colon. Examples include:
- Canned or cooked fruits without skins or seeds like applesauce, peaches, pears
- Bananas
- Melons like cantaloupe, honeydew, watermelon
- Cooked green beans, carrots, spinach
- Tomato sauce
- Tender lettuces like iceberg, romaine (no seeds)
- Well-cooked mushrooms, zucchini, pumpkin, turnips, potatoes (no skins)
Low Fiber Grains
Refined bread, pasta, cereals and grains are easier to digest. Look for low fiber or white varieties.
Lean Proteins
Low fat, tender proteins are well tolerated. Bake, broil, boil or grill lean meats, poultry, fish, eggs.
Low Fat Dairy
Small amounts of low fat milk, yogurt, cheese and cottage cheese are usually fine.
Healthy Fats
While fatty foods should be limited, small amounts of oils can make foods more palatable. Use sparingly:
- Olive oil
- Coconut oil
- Avocado oil
- Canola oil
Herbal Teas
Caffeine-free herbal teas can help hydrate and soothe digestive upset. Chamomile, ginger, peppermint are soothing choices.
Preventing Diverticulitis Through Diet
While a low fiber diet is advised during acute episodes, a high fiber diet is important for preventing diverticulitis long-term. Fiber softens and adds bulk to stool, allowing it to pass more easily through the colon to reduce pressure on diverticula.
25-35 grams of fiber per day is recommended for diverticulitis prevention. Excellent high fiber choices include:
- Whole grains like whole wheat bread, brown rice, oats
- Fruits like berries, pears, apples, bananas
- Vegetables especially broccoli, Brussels sprouts, squash, artichokes
- Beans and lentils
- Nuts and seeds
- Chia seeds and flaxseeds
Gradually increase fiber over time and stay well hydrated to allow the digestive system to adjust.
Other Tips to Prevent Diverticulitis
Along with a high fiber diet, other healthy lifestyle measures can keep diverticulitis at bay:
- Exercise regularly
- Maintain a healthy weight
- Don’t smoke
- Limit alcohol
- Manage stress
Foods to Avoid List
As a quick recap, here is a condensed list of the main foods to restrict during acute diverticulitis flare-ups:
- Nuts and seeds
- Whole grains
- Certain raw fruits and vegetables (corn, broccoli, strawberries, etc)
- Tough cuts of meat with gristle
- High fat dairy
- Fried foods
- Oils, butter
- Spicy seasonings
- Alcohol
- Popcorn, chips, crunchy snacks
Foods to Eat List
Focus on these foods when following a low fiber diverticulitis diet:
- Low fiber grains like white bread, white rice, plain pasta
- Low fiber fruits and vegetables – cooked, canned or peeled
- Lean proteins like chicken, turkey, fish, eggs
- Low fat dairy
- Clear liquids to stay hydrated
Sample Menu for a Flare-Up
Here is a sample low fiber menu that avoids diverticulitis trigger foods:
Breakfast
- Eggs – scrambled, poached, hard boiled
- Plain oatmeal, cream of wheat or white toast
- Banana
- Low fat milk
- Decaf tea or coffee
Lunch
- Soup broth based – chicken noodle, tomato, vegetable
- Tuna salad sandwich on white bread with mayo, lettuce
- Celery sticks
- Jello
- Herbal tea
Dinner
- Baked chicken breast
- White rice
- Cooked carrots
- Canned peaches
Snacks
- Low fat yogurt or cottage cheese
- Applesauce
- Peeled cucumber
- Melon
- White toast
- Broth
Conclusion
Following a low fiber diet tailored to avoid trigger foods can help manage diverticulitis flares. Be diligent about restricting high fiber foods like seeds, nuts, whole grains during acute episodes to give your colon time to rest and recover. Stay hydrated with clear fluids. Focus on lean proteins, cooked low fiber fruits and veggies, and refined carbs. Once symptoms improve, gradually increase fiber again to prevent future attacks.