Managing Diverticulitis through Good Nutrition

 

By Melanie Peters   |   June 27, 2019

Diverticula are small pouches that can develop anywhere along the digestive tract — a condition known as diverticulosis. It’s a benign and fairly common condition, occurring in 10 percent of people over the age of 40 and in 50 percent of people over the age of 60 with most never developing signs or symptoms.

But diverticula can become infected or inflamed, leading to a more serious and painful condition known as diverticulitis. Key factors that contribute to this shift are lifestyle and diet.

abdominal pain

We asked Joshua Rubin, MD, assistant clinical professor in the Division of Gastroenterology at UC San Diego School of Medicine, how diverticulitis can be avoided, which foods to choose and which to avoid if suffering from the condition. Plus a summer-inspired recipe that’s nutritious, delicious and good for your gut.

Is diverticulitis considered an inflammatory bowel disease?

Diverticulitis is not considered an inflammatory bowel disease at this time. Diverticula develop at points of weakness in the colonic wall, where the blood vessels penetrate the colonic muscle layer. Diverticulitis is caused by erosion of the wall of the diverticulum producing a micro- or macro-perforation of the diverticulum. This perforation is ultimately due to an increase in the colonic pressure within the diverticulum. The resulting perforation usually leads to a mild inflammatory process, but sometimes the process can lead to a more severe presentation that can require hospitalization.

How much does food play a role in who does (or doesn’t) develop diverticulitis? Is it in our genes?

The food we eat likely plays a large role in the development of diverticula. Industrialized, western nations have a higher prevalence of diverticulosis (the presence of diverticula) than non-industrialized western nations. The difference is thought to be due to diet and physical activity levels. As nations become more industrialized, the prevalence of diverticulosis also increases. Up to 15 percent of people with diverticulosis will develop diverticulitis. There are studies to suggest that the major lifestyle risk factors for the development of diverticulitis are a diet rich in red meat, a high-fat or low-fiber diet, smoking, obesity and a lack of intense physical activity.

Can diverticulitis be managed through nutrition? Which foods are forever off the list?

In patients with an acute episode of mild uncomplicated diverticulitis, there is currently no evidence to modify or restrict the diet. However, some physicians will place their patients on a clear liquid diet for several days and if feeling better at that time, the patient can return to a regular diet. Patients who are hospitalized with diverticulitis will often be placed on a clear liquid diet or bowel rest with IV hydration and/or nutrition depending on severity and duration of symptoms.

In terms of long-term management of patients with diverticulitis, studies have suggested that high dietary fiber intake and vegetarian diets may decrease the risk of the development of diverticulitis. It has long been thought that people with a history of diverticulitis should avoid popcorn, seeds, nuts and corn. However, a large study of 47,000 men revealed that there was no association between these foods and the development of diverticulitis. Additionally, there is no association between alcohol and caffeine consumption with the development of diverticular disease.


Here’s a recipe for a dish that’s high in fiber, low in fat and perfect for summer!
Grilled Coleslaw with Lemon-Herb Vinaigrette, courtesy of Breana Killeen, EatingWell

Prep time: 30 minutes; Cook time: 30 minutes

  • 1/4 small green cabbage (about 12 ounces)
  • 1/4 small red cabbage (about 12 ounces)
  • 1 large carrot
  • 4 tablespoons extra-virgin olive oil, divided
  • 1 large lemon, halved
  • 1 tablespoon minced shallot
  • 1½ teaspoons honey
  • 1/2 teaspoon salt
  • 1/2 teaspoon ground pepper
  • 2 tablespoons chopped fresh herbs, such as dill, parsley and/or basil
  • Preheat grill to medium.
  • Cut each cabbage quarter into 3 wedges, trying to keep an equal portion of the core attached to each wedge to hold it together on the grill. Brush the cabbage wedges and carrot with 1½ tablespoons oil.
  • Grill the vegetables, turning occasionally, until lightly charred and starting to soften, 10 to 15 minutes.
  • Grill lemon, cut-side down, until grill marks form, about 4 minutes.
  • Juice the lemon halves into a large bowl. Whisk in the remaining 2½ tablespoons oil, shallot, honey, salt and pepper. Stir in herbs.
  • Chop the vegetables into ½-inch pieces. Add to the bowl and toss with the dressing.

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