Diverticulitis vs diverticulosis

Diverticula are small pouches that can form along the lining of the gastrointestinal (GI) tract. These pouches are more common than you think, occurring in about 10% of Americans over 40 years old, 50% of those over 60 years old, and about 60-70% of those over 80 years of age. When these small pockets are present, it is called diverticulosis. Most individuals living with diverticulosis will live a normal life and may not even be aware of it.

Diverticula are harmless and rarely cause issues. However, a small percentage, less than 5%, of individuals with diverticulosis will experience an infection and inflammation of the diverticula due to bacteria or stool getting caught in the pockets, which is known as diverticulitis. Diverticulitis is painful and symptoms can include diarrhea or constipation, fever, chills, nausea, and vomiting.

Researchers are not certain what causes diverticular disease. However, many have speculated a diet low in fiber can be to blame. Fiber helps keep stool soft and move through the colon with ease. A low fiber diet can cause the stool to be too hard, creating pressure against the intestinal wall and creating these pockets or diverticula. The good news is that if diverticula have developed, there are steps you can take to control them.

Diverticulosis management

Since many individuals living with diverticula do not have symptoms, there is no treatment for diverticulosis. However, there are diet recommendations that can decrease the risk of diverticula becoming inflamed or infected, causing diverticulitis. As a preventative measure, consuming a high fiber diet can be beneficial, with a goal of 25-35 grams of fiber per day. Fiber-rich foods include whole grains, fruits, vegetables, nuts, seeds, legumes, and beans. Drinking adequate fluids is also important to keep stool soft and prevent constipation. Unless your physician has said to limit fluids, a goal of 8 cups of fluid per day is a good place to start.

In the past, it was recommended to avoid eating popcorn, nuts, and seeds if you had diverticulosis. However more recent research has suggested this isn’t necessary, and that these foods are not harmful to those living with diverticular disease.

Diverticulitis management

When infection of the diverticula occurs, receiving treatment promptly will help to avoid further complications. In mild cases, an oral antibiotic will be prescribed along with rest and certain diet recommendations. In more severe cases IV fluids or surgery may be recommended. GI rest, being unable to eat, might be indicated to allow for healing of the intestine.

During treatment, a short-term liquid diet or a low fiber diet may be recommended to allow for healing of the intestinal wall. Once the intestines have healed, a slow reintroduction of high fiber foods is recommended to keep stool moving easily through the colon. Maintaining a high fiber diet with adequate hydration will reduce the risk for recurrence.

How to increase fiber intake

If you’re not consuming adequate fiber currently, there are plenty of ways to reach the recommended intake of 25-35 grams per day. Try some of these tips to increase your daily intake.

• Eat at least 5 servings of fruits and vegetables per day, with peels or skins on. Always try to choose whole fruit or vegetables over juice, as juicing removes a significant amount of the fiber.
• Choose whole grain breads and cereals. Check the ingredient list and look for options that list whole wheat, rye, oats, or bran as the first ingredient.
• Swap white rice for brown or wild rice.
• Replace white or all purpose flour with whole wheat flour in recipes.
• Try a high fiber noodle option, such as whole wheat pasta or pasta made from lentils or legumes.
• Add beans or peas to a favorite casserole dish.
• Compare food labels to find the higher fiber option between similar foods. When reading the nutrition facts label, a high fiber food is considered one with 3-5 grams of fiber per serving.

Reach out to a registered dietitian to navigate opportunities to decrease your risk of diverticulitis and support overall digestive health.

If you have more questions about your diet, it’s always a great idea to speak with a registered dietitian. Registered dietitians are the only credentialed experts qualified to address your unique health questions. Click here to request a direct consultation with a dietitian today!

References:

Diverticulosis and diverticulitis. IFFGD. https://iffgd.org/gi-disorders/diverticulosis-and-diverticulitis/. Published March 17, 2022. Accessed June 8, 2022.

Definition & Facts for diverticular disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/definition-facts. Accessed June 8, 2022.