Diverticulitis is a condition where small pouches called diverticula form in the colon. When these pouches become inflamed, it results in abdominal pain, constipation, diarrhea, nausea, and other digestive issues. For those with diverticulitis, diet can play an important role in managing symptoms and preventing flare-ups. Many wonder if they can still enjoy pizza while following a diverticulitis diet. The good news is that there are pizza options those with diverticulitis can eat in moderation.
What is Diverticulitis?
Diverticulitis occurs when diverticula in the colon become infected or inflamed. Diverticula are small sacs or pouches that bulge outward on the colon wall. These sacs form when weak spots allow the inner colon lining to push through the muscle wall of the colon.
Diverticula are very common, especially in Western countries. Over half of all people over age 60 have diverticula in their colons. However, only about 10-25% of people with diverticula will ever develop diverticulitis.
When diverticula do become inflamed, it results in a condition called acute diverticulitis. Symptoms of diverticulitis include:
- Abdominal pain, usually in the lower left quadrant
- Constipation or diarrhea
- Nausea and vomiting
- Fever
- Chills
- Cramping
- Bloating
- A feeling of needing to pass stool even when bowels are empty
A diet high in fiber can help prevent the formation of diverticula in the first place. But once present, diverticula can become problematic if they become obstructed and infected. Diverticulitis occurs when diverticula tear and allow bacteria to spread into the colon, leading to infection and inflammation.
Pizza Ingredients to Avoid with Diverticulitis
When experiencing an acute diverticulitis flare-up, doctors usually recommend a clear liquid diet at first to give the colon a chance to rest and heal. Then, they advise slowly moving to a low fiber, low residue diet to limit irritation and prevent food from getting caught in the diverticula.
Once symptoms have resolved, many doctors recommend following a high fiber diet long term to keep things moving through the colon and help prevent future infections. However, some gastroenterologists disagree and continue to advise a low residue diet since excess fiber can theoretically aggravate the diverticula sacs.
No matter what stage of diverticulitis you are experiencing, there are certain pizza ingredients that tend to be problematic for those with this condition:
Seeds and Nuts
Foods with small seeds and nuts, like sesame seeds, sunflower seeds, and pine nuts, are typically recommended to avoid with diverticulitis. Although the evidence is limited, these foods may be able to get trapped in diverticula and cause irritation or infection. It’s best not to take the risk.
Whole Wheat Crust
The high fiber content of whole wheat pizza crust may be hard to digest for some with diverticulitis. During symptom flare-ups, a white or gluten-free crust is likely the safer option.
Raw Vegetables
Raw veggies like bell peppers, onions, tomatoes, and mushrooms are healthy pizza toppings. But they contain insoluble fiber that can be difficult to break down for those with GI issues. Cooking the vegetables first helps make them gentler on sensitive digestive systems.
Processed Meats
Pepperoni, sausage, bacon, ham and other processed meats commonly top pizzas. However, these fatty and nitrate-laden meats tend to irritate the digestive tract. They are best avoided during a diverticulitis flare-up.
Pizza Ingredients Safe to Eat with Diverticulitis
While some pizza ingredients should be limited or avoided, there are many delicious, diverticulitis-friendly options you can safely use to build a custom pizza that won’t aggravate your symptoms:
Chicken
Sliced chicken makes a lighter, healthier alternative to pepperoni and sausage. Other lean protein options like shrimp could also work.
Vegetables
When cooked thoroughly, vegetables like spinach, broccoli, zucchini, eggplant, artichokes, asparagus and potatoes can be gentle, nutritious toppings for those with diverticulitis.
Low-Fat Cheese
Cheese is an essential ingredient on any pizza. To limit fat, opt for low moisture, part-skim mozzarella. Other good options include feta, parmesan, goat cheese, ricotta and cheddar.
Gluten-Free Crust
Those with gluten sensitivity often have gut issues, so a gluten-free crust is a smart choice for diverticulitis as well. Gluten-free crusts are made with alternate flours like rice, potato, tapioca or almond.
Olive Oil
Olive oil is an excellent source of anti-inflammatory monounsaturated fats. Using olive oil instead of other oils to brush the crust or drizzle over cooked veggies adds health benefits for those with diverticulitis.
Herbs and Spices
Herbs like basil, oregano, parsley and rosemary and spices like garlic, onion, black pepper and red chili flakes add flavor without aggravating diverticulitis symptoms. They make tasty additions to white pizza sauce as well.
Building a Diverticulitis-Friendly Pizza
Now that you know which ingredients to limit and include, here are some tips for constructing a diverticulitis-friendly pizza at home:
- Use a pre-made gluten-free or white flour crust, or make your own dough with gluten-free or white flour.
- Drizzle olive oil on crust and use garlic-infused olive oil in place of sauce.
- Load up on cooked veggies like onions, spinach, zucchini, broccoli, artichokes, potatoes or tomatoes.
- Add sliced chicken breast, shrimp, or plant-based meat for protein instead of processed meats.
- Top with low-fat dairy cheese like parmesan, mozzarella or feta.
- Season with Italian herbs and spices.
- Avoid seeds, nuts, raw veggies, whole wheat flour, and processed meats.
This basic formula makes for a delicious, diverticulitis-friendly white pizza. You can experiment with endless combinations of allowed ingredients to satisfy your pizza craving while keeping GI symptoms at bay.
Lifestyle Changes and Treatments for Diverticulitis
While diet plays a key role, other lifestyle factors and treatments can also help manage diverticulitis:
Increase Fluid Intake
Staying hydrated is important, especially when experiencing a bout of diverticulitis with diarrhea. Water and clear broths help replenish lost fluids.
Exercise
Regular moderate exercise encourages intestinal motility and bowel regularity. However, intense activity may need to be limited during symptom flare-ups.
Quit Smoking
Smoking has been linked to a higher risk of diverticulitis. Quitting can help lower chances of developing this condition.
Medications
Doctors may prescribe antibiotics, anti-inflammatories, pain relievers, antispasmodics, and other medications to treat acute diverticulitis episodes. Fiber supplements may also be recommended.
Surgery
For serious recurrent cases, surgery to remove the affected part of the colon may be required. This is a last resort when other treatments have failed.
Are There Any Store-Bought Pizza Options?
Those with diverticulitis can work with restaurants and pizzerias to custom order a pizza within their dietary limits. There are also some pre-made frozen pizza options in grocery stores that may be suitable:
Gluten-Free Crust Pizzas
Many grocery stores now carry frozen pizzas made with a gluten-free crust, like pizza from Against the Grain. Topping choices are often limited however.
Cauliflower Crust Pizzas
Cauliflower crust pizzas like those from Cali’Flour Foods offer a vegetable-based crust free of gluten and wheat. You can add your own diverticulitis-friendly toppings.
Cheese Pizzas
Plain cheese pizzas like Amy’s Cheese Pizza use simpler ingredients that are gentler for sensitive digestive systems.
Margherita Pizzas
Basic margherita pizzas feature sauce, cheese and basil, though some add onions or tomatoes. The ingredients tend to be diverticulitis-friendly.
White Pizzas
White pizzas use olive oil instead of tomato sauce, making them lower in acidity. Toppings typically include cheese, garlic, spinach and onions that should be well-tolerated.
Pizza Restaurants with Diverticulitis-Friendly Options
Many national pizza chains are happy to accommodate dietary restrictions. Here are some tips and options for ordering at popular restaurants:
| Restaurant | Tips for Ordering | Menu Items |
|---|---|---|
| Domino’s | – Request a gluten-free crust – Ask for light sauce or white sauce instead of red – Load up on veggies instead of meats – Add chicken instead of sausage/pepperoni |
– Gluten-Free Crust – Chicken & Spinach Pizza – Veggie Pizza |
| Papa John’s | – Order a thin, gluten-free crust – Substitute Alfredo sauce for tomato – Add grilled chicken instead of pepperoni |
– Gluten-Free Crust – Garden Fresh Pizza – Chicken Alfredo Pizza |
| Pizza Hut | – Try the gluten-free crust – Ask for extra cheese instead of meats – Add veggies and chicken |
– Gluten-Free Crust – Cheese Lover’s Plus Pizza – Chicken Supreme |
| California Pizza Kitchen | – Order a gluten-free crust – Choose veggie instead of meat toppings |
– BBQ Chicken Pizza – Margherita Pizza |
Most local and regional pizza chains also have gluten-free and veggie options. Custom ordering is always an option as well. Being upfront with staff about dietary restrictions is key.
Homemade Diverticulitis Pizza Recipes
For full control over ingredients, making pizza at home is best. Here are some tasty diverticulitis-friendly pizza recipes to try:
1. Margherita Pizza with Gluten-Free Crust
Ingredients:
- 1 gluten-free pizza crust
- Olive oil
- Garlic, minced
- Basil leaves
- Salt
- Pepper
- 1⁄2 cup marinara sauce
- 2 cups mozzarella cheese
- Grated parmesan cheese
Instructions:
- Preheat oven to 450°F. Place crust on a pizza pan or baking sheet.
- Brush crust with olive oil and sprinkle with minced garlic.
- Spread marinara sauce thinly over the crust, leaving a 1/2 inch border.
- Cover with mozzarella cheese and grated parmesan. Top with fresh basil leaves.
- Bake for 12-15 minutes until crust is browned and cheese is melted.
- Remove from oven, slice, and serve. Garnish with more basil if desired.
2. White Pizza with Chicken and Vegetables
Ingredients:
- 1 gluten-free pizza crust
- Extra virgin olive oil
- 2 cloves garlic, minced
- 1⁄4 cup ricotta cheese
- 1 cup chicken, cooked and shredded
- 1 cup mozzarella cheese, shredded
- 1 cup baby spinach
- 1⁄2 cup onion, sliced
- 1⁄2 cup mushrooms, sliced
- 1⁄4 cup sun-dried tomatoes, chopped
Instructions:
- Preheat oven to 425°F. Place crust on a pizza pan or baking sheet. Drizzle with olive oil and sprinkle with garlic.
- Spread ricotta cheese evenly over the crust. Top with shredded mozzarella.
- Layer on chicken, spinach, onions, mushrooms and sun-dried tomatoes.
- Bake for 10-12 minutes until crust is browned and cheese is melted.
- Remove from oven, slice, and serve hot.
3. Pesto Pizza with Zucchini and Tomatoes
Ingredients:
- Store bought pesto
- 1 gluten-free pizza crust
- 2 tomatoes, sliced
- 1 small zucchini, sliced
- 1 cup fresh mozzarella, sliced
- Salt and pepper to taste
- Fresh basil leaves for garnish
Instructions:
- Preheat oven to 450°F. Spread pesto evenly over the pizza crust, leaving a 1/2 inch border.
- Layer mozzarella slices over the pesto, then top with sliced tomatoes and zucchini.
- Season with salt and pepper. Bake for 10-12 minutes until crust is browned and cheese is melted.
- Remove from oven, top with basil leaves, slice and serve.
Conclusion
Those with diverticulitis can absolutely still enjoy pizza in moderation by making smart ingredient choices. Opt for a white or gluten-free crust with olive oil instead of tomato sauce. Pile on cooked veggies and lean proteins like chicken instead of fatty meats. And always avoid small seeds, nuts, whole wheat flour, and raw veggies that can irritate diverticula. With the right homemade or customized restaurant pizza, you don’t have to miss out on this delicious comfort food while living with diverticulitis.