Diet can affect the symptoms of diverticulitis. Some foods may help prevent symptoms, while others may make a flare-up worse.

Diverticulitis is one of the most common gastrointestinal diagnoses in United States clinics, possibly due to the prevalence of a lower fiber diet. Medical treatment may include antibiotics or surgery.

Doctors may recommend that people follow a clear liquid diet during an acute flare-up of diverticulitis. Some research suggests that dietary changes — such as eating more fiber and probiotics while avoiding certain carbohydrates and red meat — could help some people with diverticulitis symptoms.

This article discusses foods to eat, foods to avoid, and other factors to consider when living with diverticulitis.

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Diverticulitis is a condition where small pouches in the intestine called diverticula become inflamed or infected. Symptoms of diverticulitis can include abdominal pain, nausea and vomiting, fever, constipation, and diarrhea.

If a person has these pouches, but they are not inflamed or infected, the person has diverticulosis and will likely have no symptoms. According to current estimates, fewer than 5% of people with diverticulosis will develop diverticulitis.

A 2018 review suggested that risk factors for developing diverticulitis include aging, having increased fat around the abdomen, an inactive lifestyle, and difficulty eating a balanced diet.

The review concluded that there is not enough quality research to identify which diets are beneficial for an acute attack of diverticulitis. But they did suggest that following a high fiber diet after recovery from acute diverticulitis might reduce the risk of another episode.

Serious complications of diverticulitis may include:

  • an abscess or perforation in the colon
  • peritonitis, which is inflammation or infection in the abdominal lining
  • a fistula, which is an uncharacteristic tunnel linking two organs or an organ and the outside of the body
  • a blockage of the movement of food or stool through the intestines

Keep reading for more information about which foods to eat and avoid with diverticulitis.

In one 2017 study on men, researchers suggested that a diet high in fruits, vegetables, and whole grains has an association with a decreased risk of diverticulitis.

A 2021 review linked a diet high in fiber with a lower risk of diverticulitis or hospitalization from diverticular disease. The review noted that fiber from fruits and cereal had a protective effect and diverticular disease, but vegetable fiber did not. It also stated that red meat consumption and a typical Western diet link to a higher risk of diverticulitis.

Fiber-rich foods

According to a 2019 study, for people experiencing acute, uncomplicated diverticulitis flares, doctors typically recommend a clear liquid diet followed by a low fiber diet until symptoms ease. More complicated cases of diverticulitis may require different treatments, such as an NPO or “nothing by mouth” order.

The Dietary Guidelines for Americans 2020–2025 recommend a dietary fiber intake of 14 grams (g) per 1,000 calories. A high fiber diet is one in which a person exceeds the dietary reference intake for fiber.

High fiber foods include:

  • high fiber ready-to-eat bran cereal
  • beans and pulses, including navy beans, chickpeas, split peas, and lentils
  • fruits, including pears, avocados, apples, and prunes
  • vegetables, including artichokes, broccoli, green peas, potatoes, squash, and parsnips
  • grains, including bulgur, quinoa, barley, and whole wheat

If any foods aggravate symptoms, a person should speak with their doctor. The University of California, San Francisco noted that some doctors might suggest a person take a fiber supplement, such as methylcellulose (Citrucel) or psyllium (Metamucil).

Probiotics

Probiotics are beneficial bacteria that help the gut stay healthy. A 2018 review that included 13 studies noted that some findings suggest that certain probiotic strains may be effective in the treatment of diverticular disease.

But a 2021 systematic review of studies indicated that studies promoting probiotic benefits for diverticulitis are not sufficient to draw any meaningful conclusions. In other words, though probiotics may not hurt a person, they also may not provide any real benefit either. Currently, it is not clear which probiotic strains are most effective, or what dose and treatment time is most appropriate for people with diverticular disease.

People interested in probiotics can take them as a supplement, but they also occur naturally in some foods. These foods include natural yogurt and fermented foods such as:

  • sauerkraut
  • kefir
  • tempeh
  • miso
  • kimchi

People who have been taking antibiotics might consider adding these foods to their diet to help repopulate their gut with beneficial bacteria.

A 2019 review of the health benefits of fermented foods suggested that the potential probiotic effects can support a healthy digestive system and may help symptoms of irritable bowel syndrome (IBS). But there is insufficient evidence to determine their impact.

A typical Western diet is high in red meat and refined grains and often includes lower fiber content. A 2017 study associated this type of diet with an increased risk of diverticulitis.

The UCSF noted that it is safe for people living with diverticulitis to eat nuts, popcorn, and seeds, including pumpkin and sesame seeds.

Experts also say that it is OK to eat the seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries. In the past, doctors may have advised people to remove these foods from their diets.

But each person is different, and some may find that particular foods worsen their symptoms.

Anyone who notices that a certain food causes pain or a change in symptoms may wish to eliminate that food and talk with their doctor or healthcare professional.

High FODMAP foods

FODMAP is an abbreviation for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are types of carbohydrates that can cause digestive symptoms, such as bloating, gas, and diarrhea in some people.

In Dietary Patterns and Whole Plant Food in Aging and Disease, the author commented that a low intake of FODMAP foods might help to lower the risk and alleviate symptoms of diverticular disease.

A 2016 hypothesis suggested that a high fiber diet, when combined with FODMAP foods, may cause excess gas that could contribute to diverticulitis symptoms.

Some high FODMAP foods include:

  • onions, mushrooms, cauliflower, and garlic
  • apples, apricots, dried fruits, pears, peaches
  • dairy foods, including milks, yogurts, and cheeses
  • legumes and pulses
  • bread and cereals
  • sugars and sweeteners

As some of these foods also contain beneficial fiber, a person should discuss their food choices and elimination with a healthcare professional before making drastic changes.

Each person will have different dietary needs and sensitivities, so doctors recommend individualized professional guidance.

Red meat

Research has linked higher intakes of red meat and processed meat with diverticulitis.

One 2017 study found that if people stick to certain lifestyle recommendations, it might be possible to prevent 50% of diverticulitis cases.

Recommendations from the study included consuming no more than 51 grams (g) of red meat a day, eating about 23 g of dietary fiber daily, doing at least 2 hours of vigorous exercise each week, maintaining a moderate weight, and never smoking.

Another study published in the journal Gut looked at biological males in the U.S. The study found that higher intakes of red meat, particularly unprocessed red meat, were associated with an increased risk of diverticulitis. The authors suggest that substituting red meat with poultry or fish may reduce risk.

Diet and other lifestyle factors play an essential part in the development of diverticulitis. For example, a 2018 review indicated that obesity, physical inactivity, and smoking might all play a role in its development.

The review also linked several medications with an increased risk of diverticulitis. Regularly using non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or opioid analgesics may increase a person’s risk.

Also, low levels of vitamin D, which people mainly obtain through exposure to sunshine, may link to diverticulitis.

The review reported that genetic factors account for about 50% of a person’s susceptibility to the condition, though research still needs to identify genetic markers. A person with a family history of diverticulitis may have an increased risk of developing the condition.

Researchers need to conduct more studies to determine which foods are beneficial for people with diverticulitis.

Currently, researchers are looking at how beneficial gut bacteria can support general health, and this may show promising results for diverticulitis. But, at the moment, there is not enough good quality evidence to make recommendations.

Fiber intake seems to be a vital component. Consuming a high fiber diet may reduce the risk of diverticulitis and improve digestive health in general. But people experiencing a flare-up may be better off avoiding high fiber foods.

Limiting red and processed meat may also reduce risk and symptoms. Replacing them with poultry, fish, and plenty of fruits, vegetables, whole grains, and legumes may be a sensible approach.

Being active, eating a balanced diet, reducing alcohol intake, and stopping smoking can support overall health and minimize a person’s risk of obesity and disease.

A person living with diverticulitis should always consult their healthcare professional or a registered dietitian to discuss how best to manage their symptoms through diet and lifestyle changes.