Sometimes, as people get older, they can develop small bulging pouches in the lining of the large intestine. These are called diverticula and the condition is known as diverticulosis or diverticular disease.
When the pouches become inflamed or infected it leads to an often very painful condition called diverticulitis. In addition to having abdominal pain, people with diverticulitis may experience nausea, vomiting, bloating, fever, constipation or diarrhoea.
Many experts believe that a low-fibre diet can lead to diverticular disease and diverticulitis. This may be why people in Asia and Africa have a very low incidence of the condition because their diet tends to be higher in fibre.
Diverticular disease often has no or few symptoms, leaving many people unaware that they even have diverticula present.
Diverticulitis may need to be treated with antibiotics or with an operation in severe cases.
Diet for diverticulitis
If you're experiencing severe symptoms from diverticulitis, in addition to antibiotics and paracetamol for pain relief, your GP may recommend a liquid diverticulitis diet as part of your treatment, which can include:
- Fruit juices
- Ice lollies
Gradually you can ease back into a regular diet. Your GP may advise you to start with low-fibre foods (white bread, meat, poultry, fish, eggs and dairy products) before introducing high-fibre foods.
Fibre softens and adds bulk to stools, helping them pass through the colon more easily. It also reduces pressure on the digestive tract.
Many studies show that eating fibre-rich foods can help control diverticular symptoms. Try to balance your diet with at least five daily portions of fruit and vegetables, plus wholegrains. Ideally, adults should aim to eat between 18g (0.6oz) to 30g (1.05oz) of fibre a day. Your GP may suggest a more targeted plan for your individual height and weight.
Here are a few fibre-rich foods to include in meals:
- Fresh fruits (apples, pears oranges)
- Dried fruits (apricots, prunes)
- Vegetables (Brussels sprouts, peas, spinach)
- Beans and pulses (baked beans, red kidney beans and lentils)
- Starchy foods (wholegrain breads, crispbreads, wholewheat pasta, brown rice)
- High fibre breakfast cereals (bran flakes, shredded wheat, porridge, muesli)
- Nuts (almonds, plain peanuts, Brazil nuts)
If you're having difficulty structuring a diet on your own, consult your GP or a registered dietitian. They can set up a meal plan that works for you.
Your GP may also recommend a fibre supplement. Supplements often come in sachets of powder to mix with water, available from local pharmacies and health food shops. Drinking enough water and other fluids throughout the day will also help prevent constipation.
Foods to avoid with diverticulitis
In the past, doctors had recommended that people with diverticular disease (diverticulosis or diverticulitis) avoid hard-to-digest foods such as nuts, corn, popcorn or seeds, because of the risk that these foods may get stuck in the diverticula and lead to inflammation. However, recent research suggests there is no real scientific evidence to back up this recommendation.
In fact, nuts and seeds are components of many high-fibre foods, which are recommended for people with diverticular disease.
If in doubt, contact your GP or a dietician for advice. You can find a registered dietitian by contacting your local hospital or GP surgery, or through several organisations including the British Dietetic Association or the Health and Care Professions Council.