Juices should have no pulp. During the clear liquid diet, you may consume:. When you're able to eat solid food, choose low fiber foods while healing. Low fiber foods include:. After symptoms improve, usually within two to four days, you may add 5 to 15 grams of fiber a day back into your diet. Resume your high fiber diet when you no longer have symptoms.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.

We encourage you to discuss any questions or concerns you may have with your provider. A diet high in fiber has about 25 grams per day. The information here will help you understand how to get that amount of fiber in your diet with supplements.

Fast food is easy and tasty, but it is often high in calories, fat and sodium. These things can be bad for you in large amounts.

Learn more here. A high-fiber diet reduces the risk of developing various diseases and is important for the health of the digestive system and lowering cholesterol. Learn more. Insoluble fiber excess c. Soluble fiber deficiency d. Total fiber deficiency. A year-old patient has undergone her first colonoscopy, which showed no abnormalities.

Your assessment of her dietary intake shows no deficient levels of any nutrients. However, she has a family history of diverticulitis, and she asks you whether she should begin fiber supplementation.

Based on recent evidence, what is your answer? No, high fiber intake may promote diverticulosis. Yes, high fiber intake may prevent diverticulitis.

No, red meat is more likely to cause diverticulosis. Yes, you have a strong family history of diverticulitis.

In light of recent studies, the role of a high-fiber diet in potentially promoting diverticulosis may be related to high intraluminal pressure as a result of which of the following? Lower colonic microbial flora levels b. Higher frequency of bowel movements c. Higher water reabsorption in the colon d.

Lower sensitization of colonic mucosa. What is the economic burden created by diverticular disease each year? What is one mechanism by which obesity has emerged as an important risk factor for the development of diverticular disease?

Promotion of inflammation b. Excessive caloric intake c. Reduction in physical activity d. Increased intraluminal pressure.

He has a long history of diverticular disease and tells you that he avoids nuts and popcorn because they may trigger an attack. What should you tell him?

Those foods may reduce the risk. The risk depends on the type of nuts. Avoid popcorn if it causes diarrhea. Based on current evidence, physical inactivity may be an important risk factor for diverticular disease for which of the following reasons?

It promotes low fiber intake. It weakens colonic muscle. It contributes to obesity. It causes high colonic pressure. Which of the following gastrointestinal disorders is associated with a higher risk of diverticular disease? Idiopathic constipation b. Irritable bowel syndrome c.

Inflammatory bowel disease d. Gastroesophageal reflux. A year-old man is admitted to the hospital via the emergency department on nothing-by-mouth status with a diagnosis of diverticulitis.

Testing has revealed that the ileocecal valve is incompetent with small-bowel distension. What may be the appropriate medical nutrition therapy? Parenteral nutrition b. Low-fiber oral diet c. Enteral nutrition d. Full liquid oral diet. References 1. Peery AF, Barrett PR, Park D, et al.

A high-fiber diet does not protect against asymptomatic diverticulosis. Tursi A, Papagrigoriadis S. Review article: the current and evolving treatment of colonic diverticular disease.

Aliment Pharmacol Ther. Everhart JE, ed. The Burden of Digestive Diseases in the United States. Washington, DC: US Government Printing Office; NIH Publication No. Freeman SR, McNally PR. Med Clin North Am. Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management.

Can J Gastroenterol. Martel J, Raskin JB. History, incidence, and epidemiology of diverticulosis. J Clin Gastroenterol.

Aydin HN, Remzi F. Colonic diverticular disease. Cleveland Clinic Center for Continuing Education website. August 1, Accessed June 12, Jung HK, Choung RS, Locke GR 3rd, Schleck CD, Zinsmeister AR, Talley NJ. Diarrhea-predominant irritable bowel syndrome is associated with diverticular disease: a population-based study.

Am J Gastroenterol. Ambrosetti P, Robert JH, Witzig JA, et al. Acute left colonic diverticulitis in young patients. J Am Coll Surg. Spivak H, Weinrauch S, Harvey JC, Surick B, Ferstenberg H, Friedman I.

Acute colonic diverticulitis in the young. Dis Colon Rectum. Konvolinka CW. Acute diverticulitis under age forty. Am J Surg.

Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL. Obesity increases the risks of diverticulitis and diverticular bleeding.

Ben Yaacoub I, Boulay-Coletta I, Jullès MC, Zins M. CT findings of misleading features of colonic diverticulitis.

Insights Imaging. Sugihara K, Muto T, Morioka Y, Asano A, Yamamoto T. Diverticular disease of the colon in Japan. A review of cases. Unlu C, de Korte N, Daniels L, et al. A multicenter randomized clinical trial investigating the cost-effectiveness of treatment strategies with or without antibiotics for uncomplicated acute diverticulitis DIABOLO trial.

BMC Surgery. Etzioni DA, Mack TM, Beart RW, Kaiser AM. Diverticulitis in the United States: changing patterns of disease and treatment. Ann Surg. Young-Fadok TM. Diverticular disease of the colon. Accessed June 14, Decher N, Krenitsky JS. Medical nutrition therapy for lower gastrointestinal tract disorders.

In: Mahan LK, Escott-Stump S, Raymond JL, eds. Krause's Food and the Nutrition Care Process. Louis, MO: Saunders; Such a diet may also improve your cholesterol and help prevent heart disease.

The following information should help guide you through the process of increasing the amount of fiber in your diet. Fiber is found in plants and is generally not digested or absorbed by the body. Many different types of fiber exist. They can be separated into two broad categories.

Each has a role in promoting good health. The two types of fiber are water soluble and water insoluble. Water soluble fibers can aid in the treatment of high cholesterol levels, diabetes and obesity. By forming a gel, water soluble fibers stay in your stomach longer and help slow food absorption.

Water-soluble fibers are found in oats, bran, dried beans, potatoes, seeds, apples, oranges, and grapefruit. Insoluble fibers hold water to produce softer, bulkier stools.

These fibers are found in wheat and corn brans, nuts and many fruits and vegetables. By promoting better regularity, a diet high in insoluble fibers helps relieve constipation and control diverticular disease.

People with diverticular disease are encouraged to eat a high fiber diet. The latest data show that one need not avoid pits, nuts, or seeds with diverticulosis.

Actually, as reported in a study of men only, popcorn and nuts may be protective against both diverticulitis and diverticular bleeding. Note that many fiber values listed on labels, cookbooks and other reference materials use crude fiber values which are now outdated. Therefore, it is recommended that you use the dietary fiber values listed on the following pages when planning your meal menus.

High fiber foods offer a great plus for dieters! Many high fiber foods are naturally bulkier and more filling than refined foods; you tend to eat consume less calories on high fiber diets. When increasing your dietary fiber, remember to include a variety of soluble and insoluble fiber food sources including whole grain breads and cereal, fruits and vegetables.

Though more research is needed, future studies are likely to support modulating gut bacteria through a high fiber diet and probiotic supplementation. Depending on the severity of an acute diverticulitis flare-up, a diet low in fiber or a clear liquid diet may be beneficial to reduce symptoms.

If you have diverticulitis, talk with your doctor about your food needs and food restrictions. If you need additional guidance, ask your doctor to refer you to a dietitian. Seek out a healthcare professional who has experience working with people who have diverticulitis if you can.

In addition, stay in communication with your doctor about your condition. Read this article in Spanish. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

VIEW ALL HISTORY. A doctor may recommend a low fiber diet to help treat certain digestive problems, or before or after surgery. Learn more about foods to eat and avoid…. The low FODMAP diet can drastically improve digestive symptoms for many people.

This article explains everything you need to know about this diet. A FODMAP is a type of carbohydrate that can cause digestive problems. This article explains what FODMAPs are and who should avoid them. Find out what conditions may be causing your stomach pain at night, as well as when you should go see your doctor.

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Learn what other stomach bugs might cause a rash. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. What to Eat on a Diverticulitis Diet.

Medically reviewed by Jillian Kubala, MS, RD , Nutrition — By Sarah Coppola — Updated on February 24, Foods to avoid Should I avoid fiber? Foods to avoid with diverticulitis. Should I avoid high fiber foods? What foods should I eat during a diverticulitis flare? Does a high fiber diet reduce risk of diverticulitis?

Is it advanced with fixed changes in the colon? Are there symptoms? Or is it acute diverticulitis where the colon is recovering from infection around these pockets? Go to High Fiber Diet for full details.

The goal is to increase the daily fiber to 20, 30 or even 40 grams per day. You do not want to do this all at once, and, especially with excessive amounts of soluble fiber as this fiber is the one that, if taken to excess, promotes the bacterial production of harmless colon gas and flatus.

This fiber, also known as roughage or bulk, does not dissolve in water but paradoxically hangs onto water in the large bowel. This creates a large, soft and bulky stool. It promotes regularity and seems to be associated with a reduced chance of getting colon polyps and colon cancer, as we believe cancer inciting agents are swept through the bowel in a more rapid manner.

In addition, it may promote weight loss and it can enhance diabetic control. Foods that are high in insoluble fiber are:. Fiber Content of Foods , provides detailed information on the insoluble fiber content of many foods.

This plant fiber does dissolve in water. In the colon, it provides food for the enormous number of bacteria that thrive there and, in so doing, provides many health benefits.

Soluble fibers also promote regularity by increasing growth of the colon bacteria. Foods that are high in soluble fibers are:. Fiber Content of Foods , provides information on the soluble fiber content of many foods. From time immemorial, physicians have been advising patients with diverticulosis to avoid these items.

It was just like dried seeds inside a gourd that you can hear rattling around when you shake it. I have never agreed with this.

I have never heard a patient rattling after eating these things. Furthermore, all of these items become digested or totally sodden and soft by the time they reach the colon. Most important of all, they contain excellent amounts of fiber, which is exactly what the colon wants. So, I have always recommended nuts, seeds and popcorn for diverticulosis patients.

Now, I have been supported in this recommendation by a 2, study where a large number of diverticulosis patients who took these foods were matched against those who did not. You guessed it. The ones eating nuts, seeds and popcorn had less diverticulosis problems than those who did not.

Prebiotics are the relatively newly discovered types of plant fiber that have been shown to promote beneficial changes in the colon.

These are present in certain plant foods as well as in our prebiotic products. In diverticulosis, all the soluble fiber foods and supplements can be a healthy addition. Most of the evidence for the fiber hypothesis comes from epidemiologic studies and small clinical trials, and even these have yielded conflicting results.

The Health Professionals Follow-Up Study provided some of the more compelling evidence for the fiber hypothesis. However, there had been several missing links between the hypothesis and the data. For example, many assume that constipation, which leads to straining and high intraluminal pressure, plays a causative role in the development of diverticular disease.

Peery and colleagues conducted a cross-sectional study of 2, subjects aged 30 to Even more stunning was the dose-response relationship between fiber intake and the number of diverticula, with the highest quartile of intake associated with the presence of more than three diverticula.

In attempting to reconcile the study results with the fiber hypothesis, the first possible consideration is that patients seeking a colonoscopy may have had previous symptoms and either started a high-fiber diet on their own or on the advice of their physicians.

However, most of the colonoscopies were for routine screening. In addition, the researchers excluded a subset of subjects who previously had undergone colonoscopies with no change in the data.

squatting theory47 suggests that the sitting position causes high intraluminal pressure, more frequent bowel movements would be expected to result in a condition of higher colonic pressures.

The reason high fiber intake may not help prevent diverticulosis may be related to different physiologic mechanisms that lead to the development of diverticulosis rather than diverticulitis. However, the results do raise an intriguing conundrum: High fiber may be beneficial for patients who have diverticulitis, but it actually may promote the development of diverticulosis in individuals with no prior diverticular disease, putting them at risk of diverticulitis.

Treatment: Nutrition and Lifestyle Recommendations Although the Peery study has raised questions about the benefits of dietary fiber for preventing diverticulosis, the recommendations at this time remain the same.

So for patients who have diverticulosis and those who have had diverticulitis, which is the triggering event for most patient contact with an RD, high fiber intake is beneficial. And for patients recovering from diverticulitis, the short-term low-fiber and long-term high-fiber approach still applies.

Moreover, the abundance of research shows other health benefits of fiber, such as the prevention and treatment of cardiovascular disease, diabetes, and some cancers. Some of these benefits specifically are related to soluble fiber, which also appears to positively affect intestinal flora.

In addition, soluble fiber is a substrate for the production of short-chain fatty acids, which serve as a fuel source for colonic cells. Obesity—especially abdominal obesity—appears to be an important risk factor for diverticular disease.

In addition, as with fiber, strong evidence links obesity to several chronic diseases. For both reasons, modest weight loss in patients who are obese and maintaining a healthy body weight in others is an important component of nutrition and lifestyle recommendations in diverticular disease.

Another aspect of lifestyle that may be helpful, despite scant evidence linking it to diverticular disease, is to engage in consistent physical activity in an effort to achieve and maintain a healthy weight.

Some foods, such as fruits and vegetables, lower the level of plasma inflammatory markers, while other foods and cooking methods increase these markers. Foods that promote inflammation are those containing significant amounts of starch and sugar but small amounts of fiber.

The grilling method of cooking meats, poultry, and fish also promotes inflammation by forming advanced glycation end products. Even without more evidence, as with fiber and physical activity, foods that lower systemic inflammation also are associated with a reduced risk of several chronic diseases.

Advice for RDs Until further research corroborates the Peery study, RDs can be confident in current nutritional recommendations for patients and clients who have had diverticulitis, if not diverticulosis. The nutrition and lifestyle recommendations that may be beneficial for diverticular disease parallel those that RDs routinely emphasize in various practice settings.

Dietetic practice must be based on available evidence and not on concepts that have simply become accepted over time. She also is a past president of the Michigan Academy of Nutrition and Dietetics.

Learning Objectives After completing this continuing education course, nutrition professionals should be better able to:. Assess the public health significance of diverticular disease relative to its prevalence in the population, potential complications, and related health care costs.

Evaluate the role of dietary fiber and other nutritional factors in the development or exacerbation of diverticular disease. Provide an evidence-based rationale for all nutrition recommendations for diverticular disease. CPE Monthly Examination 1.

In distinguishing the various terms related to diverticulosis, diverticulitis, and diverticular disease, to what does the latter term refer? The inflammation and infection of diverticula lining the intestinal tract b. The presence of more than one diverticulum typically in the sigmoid colon c.

Any complication caused by the inflammation and infection of diverticula d. Various clinical states with herniation of intestinal mucosa through the wall. Total fiber excess b. Insoluble fiber excess c. Soluble fiber deficiency d. Total fiber deficiency. A year-old patient has undergone her first colonoscopy, which showed no abnormalities.

Your assessment of her dietary intake shows no deficient levels of any nutrients. However, she has a family history of diverticulitis, and she asks you whether she should begin fiber supplementation. Based on recent evidence, what is your answer? No, high fiber intake may promote diverticulosis.

Yes, high fiber intake may prevent diverticulitis. No, red meat is more likely to cause diverticulosis. Yes, you have a strong family history of diverticulitis. In light of recent studies, the role of a high-fiber diet in potentially promoting diverticulosis may be related to high intraluminal pressure as a result of which of the following?

Lower colonic microbial flora levels b. Higher frequency of bowel movements c. Higher water reabsorption in the colon d. Lower sensitization of colonic mucosa.

What is the economic burden created by diverticular disease each year? What is one mechanism by which obesity has emerged as an important risk factor for the development of diverticular disease? Promotion of inflammation b.

Excessive caloric intake c. Reduction in physical activity d. Increased intraluminal pressure. He has a long history of diverticular disease and tells you that he avoids nuts and popcorn because they may trigger an attack.

What should you tell him? Those foods may reduce the risk. The risk depends on the type of nuts. Avoid popcorn if it causes diarrhea.

Based on current evidence, physical inactivity may be an important risk factor for diverticular disease for which of the following reasons?

It promotes low fiber intake. It weakens colonic muscle. It contributes to obesity. It causes high colonic pressure. Which of the following gastrointestinal disorders is associated with a higher risk of diverticular disease?

Idiopathic constipation b. Irritable bowel syndrome c. Inflammatory bowel disease d. Gastroesophageal reflux. A year-old man is admitted to the hospital via the emergency department on nothing-by-mouth status with a diagnosis of diverticulitis. Testing has revealed that the ileocecal valve is incompetent with small-bowel distension.

What may be the appropriate medical nutrition therapy? Parenteral nutrition b. Low-fiber oral diet c. Enteral nutrition d.

Full liquid oral diet. References 1. Peery AF, Barrett PR, Park D, et al. A high-fiber diet does not protect against asymptomatic diverticulosis.

Tursi A, Papagrigoriadis S. Review article: the current and evolving treatment of colonic diverticular disease. Aliment Pharmacol Ther. Everhart JE, ed.

The Burden of Digestive Diseases in the United States. Washington, DC: US Government Printing Office; NIH Publication No. Freeman SR, McNally PR. Med Clin North Am. Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management. Can J Gastroenterol.

Martel J, Raskin JB.