Vegetables are good for you; there’s no denying that. But when you’re having a diverticulitis flare-up, they can make matters worse.
In the short term, your doctor will probably have you avoid all vegetables. Once you’ve recovered from a flare-up, though, fiber-rich vegetables are an important part of an eating plan to avoid having another one.
Diverticulosis vs. Diverticulitis
The umbrella term “diverticular disease” includes both diverticulosis and diverticulitis.
According to Mayo Clinic, diverticulosis describes a condition in which small pouches, called diverticula, form in the lining of your digestive tract, usually your large intestine or colon.
This isn’t a problem unless those pockets become infected and inflamed. If that happens, that is called diverticulitis. It’s a serious condition that needs treatment.
To fully understand the difference, it’s helpful to back up a little bit and explain how the pouches associated with diverticular disease develop.
According to the International Foundation for Gastrointestinal Disorders, when you’re born, your intestines are smooth and free of any bulges or pouches. However, as you age, increased internal pressure on your intestinal wall can push out against the lining of your digestive tract and create one or several bulges.
The American Society for Gastrointestinal Endoscopy (ASGE) says approximately half of the U.S. population has diverticulosis by the time they reach 60 years old. After 80, almost everyone has some pouches.
While the vast majority of people who have diverticula don’t realize it because they don’t have any symptoms, research has found that a small number, about 4 percent, do go on to experience diverticulitis.
Symptoms of Diverticulitis
If the pouches become inflamed or infected and diverticulitis develops, you’ll experience some uncomfortable digestive symptoms.
According to Johns Hopkins Medicine, the most common symptom is pain in the lower left part of your abdomen. Other possible symptoms include:
- Cramps
- Bloating
- Nausea
- Vomiting
- Chills
If you’re experiencing these symptoms and you suspect diverticulitis, check in with your doctor to confirm or rule out the diagnosis. If they confirm diverticulitis, your doctor may recommend a specialized diet along with other treatments, if necessary, during the flare-up.
Foods to Avoid
If you have diverticular disease, diet can be an invaluable tool in managing flare-ups and the symptoms that come with them.
In the beginning stages of a flare-up, you’ll have to completely avoid all vegetables and solid foods, according to UCSF Health.
Depending on the severity of your symptoms, your doctor may prescribe antibiotics. They’ll also likely prescribe a short-term, clear liquid diet to take the stress off your digestive system and allow the inflammation to come down.
When following a clear liquid diet, you must avoid all solid food, but you can have:
- Broth
- Clear juices, like apple, cranberry, and grape, with no pulp
- Gelatin
- Ice pops
Although there are a lot of foods to avoid for diverticulitis, Mayo Clinic notes that once you start feeling better, your doctor will let you know when you can start eating some solid, low-fiber foods again.
When you get the green light, you’ll still have to avoid eating raw vegetables and anything with a stringy texture, like celery. But you can safely include other types of well-cooked and canned vegetables in your diet as well as other low-fiber foods, like eggs, cheese, yogurt, cooked fruit, poultry, and ground meat.
Once symptoms improve, usually after two to four days, you can slowly add fiber back into your diet, limiting your intake to 5 to 15 grams per day, according to UCSF Health.
Once symptoms resolve, you can switch to a high-fiber diet, making sure to include a variety of vegetables.
Fiber and Diverticulosis
Because rates of diverticulosis are lower in areas where people follow a high-fiber diet, many healthcare professionals believe the condition develops, at least in part, as a result of not getting enough fiber, according to the ASGE.
When you don’t eat enough fiber, waste doesn’t move through your digestive system as easily, and constipation can develop. If this happens, it increases pressure in the intestines.
The increased pressure — and the straining to have a bowel movement that’s associated with constipation — may lead to diverticulosis.
However, when you eat fiber, it pulls water into your stool, softening it and making it easier to pass so you can reduce the pressure on your intestinal wall, simultaneously reducing your risk of diverticulitis.
That’s why UCSF Health says following a high-fiber diet after your diverticulitis symptoms have resolved may help prevent future attacks.
Diverticular Disease Diet
Although the amount of fiber your doctor recommends for you may be different from the general recommendation, experts typically suggest getting between 20 and 35 grams of fiber every day to keep your bowel movements regular and reduce the risk of a diverticulitis attack, according to Johns Hopkins Medicine.
According to Mayo Clinic, you can increase your fiber intake by eating lots of fiber-rich vegetables, like:
- Green peas
- Broccoli
- Collard greens
- Baked potatoes (white and sweet)
- Brussels sprouts
- Cauliflower
Even lower-fiber veggies like lettuce can help you reach your goal. If you find that you don’t tolerate raw vegetables well, you can make them easier on your digestive tract by cooking them first.
In addition to eating vegetables, you can make sure you’re getting enough fiber every day by including a variety of other fiber-rich foods in your diet, like:
- Beans
- Lentils
- Chia seeds
- Quinoa
- Brown rice
- Fruit with the skin, if you can tolerate it
Slowly Increase Your Fiber Intake
If you’re not used to getting a lot of fiber, or you’re coming off a recent diverticulitis flare-up, it’s best to increase your intake of fiber gradually instead of all at once.
UCSF Health says eating too much fiber too soon can cause uncomfortable symptoms, like gas and bloating. Instead, increase your intake slowly over a period of two weeks to give your body time to adjust to your new diet.
Make sure you’re also drinking enough water. Water helps your body use fiber to keep your stools soft and bulky. UCSF Health recommends drinking eight glasses of water per day and getting regular exercise to help keep things moving.
While this general diet plan works well for many people, everyone is different. The National Institute of Diabetes and Digestive and Kidney Diseases recommends paying close attention to your symptoms and how you feel.
If you notice that certain vegetables or high-fiber foods bother you or worsen your symptoms, cut them out of your diet and find different foods or fiber supplements, like bran and psyllium, to help you meet your fiber needs.
