Department of Nutrition and Dietetics



Department of Nutrition and Dietetics

Dietary Management of Diverticular disease

What is diverticular disease?

Diverticula (singular. diverticulum) are small bulges of the inner lining of the colon (large bowel), through the muscle wall of the bowel. They look like small pockets with a narrow internal opening. The presence of diverticula in the colon is known as diverticulosis. These diverticula are thought to develop due to localised pressure on a weak area of bowel and may be associated with chronic constipation or a relatively low intake of dietary fibre over many years. They are more frequently found in later life, although people of all ages may develop them.

Diverticular disease is the term that refers to both diverticulosis and diverticulitis. Chronic discomfort or disturbance of bowel habit without other features of inflammation may occur in association with diverticulosis and this is known as symptomatic diverticular disease.

Many people have diverticula for years without knowing. However, when one or more diverticula become inflamed, this may cause pain, diarrhoea and fever. Inflammation of diverticula is called diverticulitis. In the most severe cases, a diverticulum may perforate, leading to the development of an abscess.

Diet and diverticular disease

If you have been diagnosed with diverticular disease then modifying the fibre content of your diet may help to improve your symptoms and encourage long-term avoidance of subsequent symptom episodes.

Fibre is the part of plant foods that our digestive system is unable to break down (roughage). It is found in fruits, vegetables and cereals. When symptom-free, you should aim to eat a diet high in fibre to keep your stools soft, avoid constipation and therefore reducing the risk of hard pellets of faeces lodging within the diverticula. During an episode of diverticulitis, you may need to reduce the fibre in your diet temporarily, in order to alleviate symptoms. Fibre should be gradually reintroduced once symptoms subside.

The table below indicates which foods may constitute part of a high fibre or low fibre diet. The amount of fibre that you are able to tolerate to aid symptom management will vary from person to person.

Guide to High Fibre and Low Fibre Foods

|High Fibre Foods |Low Fibre foods |

|(for when symptom-free) |(for during episodes of diverticulitis) |

|All Fruits |Tinned peaches, pears, apricot |

|(aim for at least five portions of fruit and vegetables per day) |Stewed fruit without the skin or seeds |

| |Fruit which has been peeled with seeds/pips removed |

|All Vegetables and salad |Potatoes without the skins |

|(aim for at least five portions of fruit and vegetables per day) |Peeled cooked root vegetables, e.g. carrot, swede |

| |Tomatoes and cucumbers without the skins or seeds |

|Wholemeal/wholegrain/seeded bread |White bread |

|Products baked with wholemeal flour e.g. Digestives, wholemeal crackers, |Products baked with white flour e.g. rich tea biscuits, cream crackers, |

|flapjacks |rice cakes |

|Wholemeal pasta |White pasta |

|Brown rice |White rice |

|Weetabix, shredded wheat, fruit and fibre, muesli, Porridge oats |Cornflakes, rice crispies, sugar puffs, Ready Brek |

|Beans and pulses e.g. lentils, chickpeas |Houmous |

|Nuts, seeds | |

|Yoghurt containing dried fruit, nuts or cereals |Smooth yoghurts, custard, mousse |

|Jam, marmalade, peanut butter |Seedless Jam, shredless marmalade, |

| |chocolate, boiled sweets |

Milk, cheese, meat, fish and eggs are suitable during episodes of diverticulitis and for when you are symptom-free.

Please ask your consultant for a referral to the dietitian if you would like more detailed dietary advice.

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Produced by the Department of Nutrition & Dietetics

Surrey & Sussex Healthcare Trust

November 2012

Review: August 2015

REF:05-FIRSTLINECDSTRICTURE

Produced by the Department of Nutrition & Dietetics and Mr Neil Smith January 2013

Surrey & Sussex Healthcare Trust

Review date: January 2016

REF:05-DIVERTICULAR

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