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Dietary management of diverticular disease

Patient information A-Z

What are diverticula?

Diverticula (singular. diverticulum) are small bulges in the inner lining of the colon (large bowel). They look like small sacs with a narrow opening. These diverticula often develop due to localised pressure on a weak area of bowel and may be associated with chronic constipation and a low intake of dietary fibre. They are more commonly found in later life although people of all ages can develop them.

A simple anatomical diagram showing the diverticula.

What is diverticular disease?

The condition of having diverticula is known as diverticulosis.

Most people with diverticulosis don’t have any symptoms and many people have diverticula for many years without knowing. However diverticula can sometimes become inflamed and this may cause pain, diarrhoea and fever. If one or more diverticulum are inflamed this is called diverticulitis.

Diverticular disease is the term that refers to both diverticulosis and diverticulitis.

Diet and diverticular disease

If you have been diagnosed with diverticular disease then gradually modifying the fibre content of your diet may help to improve symptoms and aim to avoid subsequent symptom episodes in the long

term. Fibre is the part of plant foods that our digestive system is unable to break down fully. It is found in fruit, vegetables, cereals, nuts, seeds and legumes.

A medium to high fibre diet is recommended for people with diverticular disease. This can help stools to become larger, softer and thus easier to pass. This is beneficial because small pellet like stools are more likely to become lodged inside a diverticulum, which may result in inflammation. A high fibre diet may also prevent further diverticula from developing.

It is important to drink plenty of fluid when increasing fibre intake and be reasonably physically active, to help prevent/ treat any constipation.

However, if your symptoms persist, then your dietitian or doctor may recommend a trial of a low fibre diet temporarily, as during inflammation, fibre could act as an irritant. Fibre should be reintroduced gradually as soon as possible after your symptoms improve. Your dietitian will be able to support you with this.

The following expanders will give you information about which foods are high in fibre and therefore to aim to include in your diet.

Medium - high fibre foods (aim to include these in your diet)

Cereals and baked products

  • Wholemeal, brown, soya and carob flours and foods made with these flours Wholemeal pasta
  • Brown rice
  • Wholegrain cereals, eg Weetabix, All-Bran, porridge, muesli and any cereal with added nuts and/or dried fruit
  • Digestives, flapjack, biscuits containing nuts or dried fruit, eg fig rolls, Garibaldi
  • Rye and wholegrain crispbreads
  • Oatcakes

Meat, fish, fats and oils

  • Meat and fish products made with wholemeal pastry or breadcrumbs

Dairy Products

  • Dairy products with added wholegrain cereals or dried/high fibre fruits

Fruit

  • banana chips
  • bananas
  • blackberries
  • cranberries
  • currants
  • dates, figs
  • dried fruit
  • gooseberries
  • loganberries
  • prunes
  • raisins
  • raspberries
  • redcurrants
  • sultanas

Vegetables

  • baked, broad, butter, kidney beans
  • beansprouts
  • broccoli florets
  • Brussels sprouts
  • cabbage
  • cauliflower florets
  • chick peas
  • green / french / runner beans
  • lentils
  • mange-tout
  • onion
  • parsnips
  • peas
  • spinach
  • spring greens
  • sweet corn
  • sweet potato

Miscellaneous

  • Nuts, seeds
  • Peanut butter
  • Crisps
  • Wholemeal savoury snacks
  • Cereal bars
  • Confectionery containing fruit and nuts
  • Pickles and chutneys
  • Lentil, pea and bean soups
Low fibre foods

Cereals and baked products

  • White flour and baked products made with white flour, eg bread, pastry, crumbles, pasta, spaghetti, macaroni
  • White rice, tapioca, sago, cornflour, custard and blancmange
  • Rice Krispies and Cornflakes
  • Plain biscuits, eg Rich Tea, Morning Coffee, Marie
  • Plain crispbreads, crackers and rice cakes

Meat, fish, fats and oils

  • All types except those made with wholemeal pastry or breadcrumbs

Dairy Products

  • milk – all types
  • cheese – all types
  • yogurts – natural or fruit flavoured
  • fromage frais
  • cream
  • eggs

Fruit

The following foods are low fibre if their skins, pips, stalks and seeds are removed:

  • apples
  • apricot
  • cherries
  • grapefruit
  • grapes
  • kiwi
  • lychees
  • mango
  • melon
  • oranges, nectarines, tangerines
  • pears
  • peaches
  • pineapple
  • plums
  • rhubarb
  • strawberries

Vegetables

  • asparagus
  • aubergine
  • beetroot
  • carrot
  • celery
  • courgette
  • cucumber
  • leeks
  • lettuce
  • marrow
  • mushroom
  • pepper
  • potato
  • radish
  • swede
  • tomato

Miscellaneous

  • Ice cream, lollies, sorbets
  • jelly, milk puddings
  • honey, syrup, lemon curd
  • jam, marmalade (avoid pips/seeds)
  • Marmite, Bovril
  • corn snacks
  • boiled sweets, chocolate, toffee
  • seasoning, spices
  • tea, coffee, cocoa, Ovaltine
  • squashes, fizzy drinks
  • fruit juices
  • soups, Oxo

If your symptoms do not improve with a change in diet, please contact your dietitian for further advice on 01223 216655.

Your dietitian is: . . . . . . . . . . . . . . . . . . . . . . . . .

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Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.

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