The Diverticulitis Diet Explained: Simple Steps to Manage Your Condition

Have you ever experienced unwanted symptoms from a diverticulitis flare-up? If so, you’re not alone — over 200,000 Americans are hospitalized yearly for diverticulitis symptoms.

The good news? Less than 5% of Americans with diverticular disease will experience symptoms. More importantly, there are easy changes you can make to help reduce your risk of developing symptoms.

Dietary and lifestyle management play a crucial role in preventing diverticulitis. In this article, you’ll learn from healthcare professionals what you can do to prevent it and how to handle potential flare-ups.

What exactly are diverticulosis and diverticulitis?

Diverticulosis is a common digestive disease that causes small pouches to protrude in weak areas of the colon. One sac is called a diverticulum, whereas multiple sacs are called diverticula.

The cause of diverticulosis is not well understood, but it’s theorized that a chronically low-fiber diet may play a role. Limited fiber intake may lead to constipation, which may cause straining and potentially increase the risk of diverticula forming.

Once you have diverticulosis, it is a lifelong disease that is usually asymptomatic and typically does not require treatment or a special diet. However, a small portion of people experience the following symptoms:

• Cramps or stomach pain
• Bloating
• Loose or hard stools

Acute colonic diverticulitis, on the other hand, refers to the inflammation of the diverticula, which may result in infection. However, diverticulitis does not occur in all individuals with diverticulosis.

If diverticulitis does occur, special treatment is often needed to manage symptoms.

Collectively, diverticulosis and diverticulitis are known as diverticular disease.

During a flare-up: starting with a clear diet for diverticulitis

Diverticulitis diet management is often recommended during flare-ups. In particular, a clear liquid diet is typically advised, and doctors usually prescribe oral antibiotics to fight the infection.

To get more insight into diverticulitis flare-ups and their management, I contacted Kinga Portik-Gumbs, RDN, CDN, a New York-based gut health dietitian and founder of KingA+ Nutrition, LLC. Here’s what she says:

During diverticulitis flare-ups, the sacs in the colon wall become inflamed; think of a balloon bursting slightly. Bowel rest, which involves a clear liquid diet with advancement to low-fiber foods, is a common management method that provides the colon a chance to rest and reduces inflammation by limiting digestive activity. This is particularly important to prevent further complications like abscesses or perforation and support healing.

Kinga Portk-Gumbs, RDN, CDN

Here are certain foods you can include on a clear liquid diet:

Some of these foods are high in sugar, particularly added sugars; however, in my professional opinion, including these foods on a clear liquid diet is important to help meet overall calorie needs and help prevent blood sugar lows.

Further, this diet is only meant to be short-term, and thus, it is unlikely that consuming foods high in added sugar for a few days would have significant long-term health impacts for the otherwise typically healthy adult.

While fiber is beneficial for overall digestive health, in cases of flare-ups from diverticulitis symptoms, a low-fiber diet may be necessary in the short term (1–3 days) to manage symptoms.

Recovering from a flare-up: slowly introducing solid foods

As you begin to feel better and your diverticulitis symptoms improve, you can try eating solid, low-fiber foods to aid your recovery.

Here are some examples of low-fiber foods that are proposed to be more gentle on the gastrointestinal tract and may contribute to diverticulitis symptom management:

• Eggs
• Seafood
• Fish
• Chicken
• Limited dairy
• Canned or cooked fruit
• White bread
• Low-fiber grains like rice

Some health practitioners suggest staying on a bland, low-fiber diet until your symptoms subside. Then, you can begin to slowly add more fiber to your diet.

The BRAT (bananas, rice, applesauce, and toast) diet is a simple, bland diet that may be suitable for some individuals experiencing flares.

If symptoms do not improve after one week, reach out to a healthcare provider.

Although considerable research has investigated diverticular disease, clinical guidelines for the best diverticulitis diet management plan are not well established due to the difficulties in gathering high-quality research in this population.

What are the foods to limit during recovery from a diverticulitis flare-up?

During diverticulitis flares, clinical guidelines suggest avoiding a high-fiber diet.

However, research is limited, and the evidence is conflicting on whether or not a low-fiber diet is always necessary.

Ultimately, from my experience working with patients during a diverticulitis attack, patients often prefer a low-fiber or clear liquid diet as they find it gentler on their digestive system. Further, following a low-fiber diet in the short term is unlikely to be harmful.

If you choose to consume lower-fiber foods, here is a list of fiber-rich foods you may want to consider limiting during flares:

• Popcorn
• Nuts and seeds
• Whole grain cereals
• Brown rice
• Whole grains
• Whole wheat bread
• Beans and legumes like kidney beans

In addition to limiting high-fiber foods, you may want to limit or temporarily avoid spicy, fried foods, highly processed foods, and foods high in added sugar, as these may also irritate the digestive system or contribute to diverticulitis symptoms.

When can I return to a regular diet after diverticulitis?

As a dietitian who has worked with individuals with diverticulitis, I can say that the time it takes to return to a normal diet varies depending on the individual. Typically, it takes a few days to a week.

If you are still experiencing symptoms after one week and cannot progress your diet, reach out to your healthcare provider.

Long-term management: preventing future flare-ups

In the long term, a high-fiber diet is recommended to help prevent future flares and maintain optimal digestive health.

If you have recently recovered from a flare, gradually add fiber back into your diet. For example, I’ve had clients start by replacing white bread with whole wheat bread for one to two days. Then, adding in more fiber-rich foods like beans and legumes for a few days, and so forth.

I have found that some individuals I’ve worked with struggle to meet fiber needs through diet alone; in such cases, sometimes a fiber supplement can help meet daily needs.

What do other dietitians say about managing diverticulitis flare-ups? Not surprisingly, Julie Balsamo, Gut Health Dietitian Nutrition By Julie & Remote Dietitians aligns with the science:

For diverticulitis, my goal is to reduce inflammation and support the gut lining, immune system, and microbiome. A fiber-rich, whole-food diet that includes cooked veggies, omega-3s, and fermented foods can help prevent flares. Limiting highly processed foods also supports a calmer, more resilient gut.During a flare, soothing, low-residue options like bone broth and pureed veggies ease digestive stress. Supporting nervous system regulation through stress management is also key, as gut motility and inflammation are associated with chronic stress.

Julie Balsamo

On another note, adequate fluid intake is also important to help prevent constipation. Water or unsweetened beverages like tea or milk are optimal.

Fluid requirements vary greatly depending on factors like:

• Body size
• Physical activity
• Temperature

Thus, the best way to estimate your fluid needs is to monitor your urine; pale lemonade-colored urine typically indicates adequate hydration.

Another theorized prevention strategy to potentially reduce the risk of developing diverticulitis is adopting a low-FODMAP diet.

Low-FODMAP diet

The low-FODMAP diet limits certain types of carbohydrates that can easily ferment in the digestive tract of some individuals.

The theory is that eating a high-fiber diet may actually put pressure on the lower digestive tract and cause diverticulitis flares, while a diet limiting high-FODMAP foods may help reduce pressure on the colon and reduce the risk of flares.

Regardless, low-FODMAP foods as a prevention method have not been studied rigorously, so theories on this management method should be widely cautioned until robust scientific research is conducted. Further, in my professional opinion, following a diet low in FODMAPs for diverticulitis prevention is not the best option. It may limit fiber, which is important for overall health and is likely unnecessary.

Low-FODMAP diets may help some individuals with other digestive health concerns, like those with irritable bowel syndrome (IBS). However, this diet has not been well studied in those with diverticular disease, and if not appropriately followed with the help of a dietitian, nutrient deficiencies may occur long-term. Further, even in the IBS population, the low-FODMAP diet is only meant as a temporary measure for possible symptom management and is not meant to be followed long-term.

Are there specific things that cause flare-ups?

Research indicates there may be specific triggers that increase the risk of diverticulitis.

A recent systematic review indicated red meat and a Westernized diet pattern (which includes highly processed foods) may increase the risk of diverticulitis flares. One possible theory is that high long-term red meat consumption is potentially associated with inflammation occurrence risk.

However, higher-quality studies are warranted to understand if red meat and highly processed foods negatively impact flares.

On another note, high-fiber foods like popcorn, nuts, and seeds have commonly been thought to trigger flare-ups, but emerging science is suggesting otherwise. In fact, some research indicates that consuming foods high in fiber may help prevent flare-ups.

Again, high-quality research is lacking, so results should be interpreted with caution, particularly when limiting high-fiber foods, due to their many potential benefits for overall health.

Surprisingly, evidence of alcohol consumption and flare-ups appears to be mixed. However, clinical guidelines still recommend limiting or avoiding alcohol for prevention and overall health.

Beyond food: other important considerations for diverticular disease

While dietary changes and sometimes medications are the two main management methods for diverticulitis, other lifestyle factors may help prevent flare-ups. These include:

• Adequate hydration.
• Regular physical activity. Movement may help stimulate the bowel muscles and prevent constipation.
• Talking to a doctor. If you are struggling with constipation after trying dietary or other lifestyle management strategies, speak to your doctor. In some cases, doctors may recommend laxatives or other medications.

Further, if you are looking to reduce your risk of developing diverticulosis, consider limiting or avoiding alcohol.

Working with your healthcare team

It is important that your healthcare provider is notified if you are experiencing diverticulitis flares so they can help you determine a treatment plan and assess whether antibiotics are necessary.

As discussed, there are different dietary strategies recommended depending on whether you are experiencing or preventing diverticulitis flare-ups. Working with a registered dietitian can help you understand which eating plan is best for you.

Final thoughts

Managing diverticulitis symptoms often involves dietary changes like a clear liquid diet and/or following a diet low in fiber initially.

When experiencing diverticulitis symptoms, work with a healthcare provider to help create an individualized plan that is tailored to your health needs.

Certain foods may increase your risk of developing diverticulitis, such as long-term high intake of red meat and highly processed foods.

You may be able to prevent diverticulitis by eating high-fiber foods regularly, staying hydrated, partaking in regular exercise, and limiting or avoiding alcohol.