Diverticulitis

Diverticulitis is an infection in the lower 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% — 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

While the exact cause of diverticular disease is unknown, genetics is thought to play a role. So, if someone in your family has diverticulosis or diverticulitis, you may be more likely to develop it. The risk also increases with age and over half of people 60 and older are affected.

For individuals with diverticular disease, certain lifestyle factors, such as smoking, may increase the risk of complications from it. A lack of dietary fiber and a high intake of red meat may also influence the development of diverticulitis. And people who are not physically active have a higher risk, too. Some studies suggest that certain drugs increase the risk of diverticulitis, such as long-term use of aspirin and steroids.

Treatments for Diverticulitis

If you have diverticulitis, you may need medicine to treat the infection. For serious infections, during hospital stays, your doctor may recommend a period of GI rest by having you refrain from eating for a short time. The goal is to give your bowel time to heal and allow internal bleeding to stop.

Over the 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 average American gets about half of the daily recommended amount of dietary fiber. So, make sure to include foods such as whole grains, fruits and vegetables every day. 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 Dietary Fiber do Adults Need?

Adults should aim for around 28 grams of dietary fiber each 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 that includes fruits, vegetables and whole grains. For example, adults who consume 2,000 calories per day can meet their dietary fiber needs by including the following servings:

• 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 fresh fruits and vegetables, whole grains and beans. To get the dietary fiber you need:

• Eat fruits and vegetables with peels or skins such as apples or pears, or white or sweet potatoes, 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 good source of dietary fiber.
• Choose whole-grain breads and cereals. Look for choices with 100% 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, millet, teff 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 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 3 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 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 dietary 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

In the past, people with diverticulosis or diverticulitis were told to avoid certain foods. However, research in recent years shows that for most people these foods do not cause a problem:

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

While most people can eat the foods above without problems, individual reactions may 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.