7 Foods to Avoid with Diverticulitis

Diverticulosis is the formation of small, bulging pouches in the intestines. It’s more common in older adults, and about half of adults in the United States over 60 have this condition.

Diverticulitis is the painful inflammation of these pouches and occurs in about 10 to 25 percent of people with diverticulosis.

While surgery used to be the primary treatment for diverticulitis, it is now typically treated with antibiotics and dietary modifications.

Read on to learn which foods to avoid when you have diverticulitis and which foods to include to prevent it from returning. 

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What is Diverticulitis?

Before diving into the top foods to avoid with diverticulitis, it’s important to understand the difference between diverticulitis and diverticulosis.

‍Diverticulosis is a condition in which small sacs or pouches called diverticula form in the intestines.

Typically, the presence of these pouches does not cause any symptoms.

However, the diverticula become inflamed in 10 to 25 percent of cases. This is known as diverticulitis.

Symptoms of acute diverticulitis include abdominal pain (usually in the lower left side of your abdomen), constipation or diarrhea, fevers and chills, nausea, or vomiting.

In the past, diverticulitis was treated with surgery. Now, it is managed through medication and diet.

How Does Diet Affect Diverticulitis?

Diets low in fiber and high in fat and red meat appear to increase the risk of developing diverticulosis and possibly diverticulitis.

Despite popular belief, popcorn, nuts, and seeds do not increase the risk of developing diverticulosis or diverticulitis.

In fact, these foods may even prevent the development of diverticulitis because they contain fiber.

Constipation is one of the most common risk factors for developing diverticulitis.

The muscles in your bowels contract as you strain to have a bowel movement, which can lead to the development of diverticula over time. 

This is where a high-fiber diet comes in.

Waste moves more comfortably through the digestive tract when stools are soft, decreasing diverticula pressure and preventing diverticulitis flare-ups.

7 Foods to Avoid with Diverticulitis

While you typically don’t need to avoid most foods to prevent the development of diverticulitis, your doctor may recommend modifications to your diet if you already have diverticulitis. This can include:

• Complete bowel rest (i.e., nothing by mouth for a short period of time).
• Clear fluids only.
• A liquid diet.
• A low-fiber diet.

When following a low-fiber diet, you should consume 8-12 grams of fiber daily.

If you’re unsure how much fiber you eat, consider keeping a food diary for a few days to track your intake.

Red Meat

Research suggests a diet high in red meat may increase your chance of developing diverticulitis.

To reduce your risk, consider replacing red meat (like beef, pork, or lamb) with lean proteins like poultry, fish, and eggs.

If you already have diverticulitis, avoiding red meat may be beneficial because it can be difficult to digest, which could worsen symptoms.

Processed Foods

High-fat foods may increase your risk of developing diverticulitis.

Since processed foods are often high in fat, it’s best to avoid these foods both during a diverticulitis flare and to prevent flare-ups from occurring.

Spicy Foods

While evidence is sparse regarding the impact of spicy foods on the risk of developing diverticulitis, one study showed that capsaicin, a chili pepper compound found in many spicy foods, was associated with an increased risk of diverticulitis. 

Avoiding spicy foods likely won’t prevent a flare-up of diverticulitis, but if you’re already in a flare-up, spicy foods could irritate your digestive system and worsen your symptoms.

Consider avoiding spicy foods while you’re recovering from diverticulitis.

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Nuts and Seeds

While research shows that eating nuts and seeds does not increase your risk of developing diverticulitis, you may need to avoid them if you already have it.

They can be difficult to digest and may irritate the inflamed diverticula.

Popcorn

Just like nuts and seeds, research shows that eating popcorn does not increase your risk of developing diverticulitis.

However, you may need to avoid it if you already have diverticulitis.

Popcorn is high in fiber and may irritate the inflamed diverticula, worsening your pain during a flare-up.

Dairy Products

You don’t need to avoid all dairy products with diverticulitis—just high-fat ones.

As mentioned, high-fat diets may increase the risk of developing diverticulitis.

Switch out your higher-fat dairy products for lower-fat versions. Here are some options to try:

• Skim or low-fat milk.
• Non-fat or low-fat yogurt.
• Skim or low-fat cheese.

Refined Grains

Refined grains, like white bread, pasta, and flour, are lower in fiber.

Since adequate fiber is a key factor in preventing diverticulitis, it’s typically recommended that people with diverticulosis switch to whole grains.

However, if you currently have diverticulitis, you will need to reduce your fiber intake.

In this case, it may be preferable to include refined grains in your diet to reduce your fiber intake.

Once the flare-up is over, you can go back to including whole grains in your diet and minimizing your intake of refined grains.

Alternatives to Incorporate into Your Diet

Once you’ve recovered from diverticulitis, you’ll want to reduce your risk of it occurring again.

Studies show that the best way to reduce your risk of diverticulitis is to increase your fiber intake and reduce your red meat intake. 

Lean Proteins

Studies show that red meat increases the risk of developing diverticulitis.

To reduce this risk, substitute red meat for lean proteins such as poultry, fish, eggs, low-fat dairy products, and legumes.

Legumes give you bonus points because they’re high in protein and fiber, which has been shown to reduce the risk of diverticulitis. 

Fresh Fruits and Vegetables

If you’re in a diverticulitis flare, you’ll need to avoid fresh fruits and vegetables (especially the skins) because they’re high in fiber.

However, once the flare-up has passed, you should incorporate fresh fruits and vegetables liberally in your diet because their high fiber content can relieve constipation and prevent another diverticulitis flare.

Whole Grains

Just like fresh fruits and vegetables, you’ll want to steer clear of fiber-rich whole grains if you’re experiencing a diverticulitis flare.

Once the flare has passed, try to incorporate whole grains into your diet daily.

Some whole-grain options to incorporate include:

• Whole wheat bread.
• Whole wheat pasta.
• Brown rice.
• Wild rice.
• Quinoa.
• Farro.
• Bulgur.
• Millet.
• Teff.
• Amaranth.

Try experimenting with new grains—they’re a great way to add fiber, texture, and flavor to your meals.

Healthy Fats

While high-fat diets may increase your risk of developing diverticular disease, it’s still important to include healthy fats in your meals.

Some healthy fats to incorporate include:

• Avocados (these are also high in fiber).
• Olive oil.
• Canola oil.
• Avocado oil.
• Soft margarine.
• Fatty fish (like salmon, mackerel, and sardines).
• Nut butters.

Probiotic-Rich Foods

If you want to improve your gut health, eating fermented foods (many of which contain probiotics) can help.

While not all fermented foods provide probiotics, they are still a healthy addition to your diet.

Here are some fermented foods to try:

• Yogurt (look for the word “probiotics” or “live active cultures” on the label).
• Sauerkraut.
• Kimchi.
• Kefir.
• Kombucha.
• Miso.
• Tempeh (fermented soybeans).
• Natto (fermented soybeans).

Fermented foods can be an acquired taste. Try incorporating them into meals as condiments instead of eating them plain. For example, add sauerkraut or kimchi as toppings for sandwiches, burgers, salads, or wraps.

Tips for Managing Diverticulitis Through Diet

One of the best things you can do to reduce your risk of diverticulitis is to eat a high-fiber diet.

Here are some tips for eating more fiber:

Start Slow

If your current diet is lower in fiber, your digestive system may take a few weeks to get used to increased fiber intake.

Start by making small substitutions (such as eating whole wheat bread instead of white bread) and gradually include more high-fiber choices in your diet.

Stay Hydrated

Fiber needs water to keep your bowels regular. Drinking enough water helps waste move through your digestive system.

This is important for preventing constipation.

Seeking Professional Guidance

If you continue to experience diverticulitis flare-ups despite eating a high-fiber diet and reducing your red meat consumption, you should speak with a doctor. 

Some other signs you may need to speak with a doctor include:

• Severe abdominal pain.
• Fever.
• Persistent symptoms.
• Rectal bleeding.
• Difficulty eating or drinking.
• Previous episodes of diverticulitis.

Diverticulitis can range from mild to severe.

The appropriate course of action will depend on your overall health, the severity of your symptoms, and the presence of complications.

Diverticulitis typically requires treatment with antibiotics, so it’s important to seek medical attention if you’re experiencing a flare-up.

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Takeaway

While surgery used to be the mainstay treatment for diverticulitis, it’s now typically treated with antibiotics and dietary modifications.

Since constipation is a well-studied risk factor for diverticulitis, a high-fiber diet is recommended to prevent it. 

However, if you’re experiencing a diverticulitis flare, your doctor will likely recommend a low-fiber diet while taking antibiotics to treat the infection.

In this case, it’s best to limit high-fiber foods like whole fruits and vegetables, legumes, and whole grains.

Once you’re no longer in a flare, you can return to including high-fiber foods, which may help prevent another flare-up from occurring. 

How a Dietitian Can Help

If you’re struggling with diverticulitis, a gut health dietitian can help you create an eating plan that considers your symptoms, preferences, and lifestyle. 

Find a dietitian who accepts insurance through Nourish.