Diverticular disease

Introduction

Diverticular disease is a common condition where small pouches, known as diverticulum, appear in the muscle of the bowel walls (colon). These pouches are thought to be caused by pressure in the bowel and this may be due to not having enough fibre in the diet.

If the pouches become inflamed or infected the condition is called ‘diverticulitis’ and may be cause you lower abdominal pain or tenderness, abdominal distension, irregular or altered bowel habit, diarrhoea, bleeding from the back passage, sickness or fever.

Diet for diverticular disease

If you have diverticular disease but do not have any of the symptoms of diverticulitis mentioned above it is recommended that you include plenty of fibre and fluid in your diet.

How to increase the fibre in your diet

Choose wholemeal, brown or granary versions of bread, pasta, rice and flour as these contain more fibre than white versions. Also choose wholegrain and high fibre breakfast cereals, e.g., porridge, shredded wheat, bran flakes.

Aim to eat at least five portions of fruit and vegetables each day. This can include fresh, frozen or tinned varieties. You could also try adding a handful of dried fruit to cereal.

It is important you drink plenty when increasing your fibre intake. Aim for 8 to 10 cups of fluid per day. This can include tea and coffee as well as water.

Do you have a poor appetite?

If you have a poor appetite you may find that increasing the fibre in your diet means you feel full quicker and that you are eating less. If your appetite is poor then try the following:
• Aim for three small meals per day with two or three snacks between meals.
• Choose full fat milk, aim for 1 pint per day for drinks, to make desserts and add to cereal.
• Add additional butter and / or cheese to vegetables, sauces, soups and to meals.

Diet for when you have symptoms of diverticulitis

When you have the symptoms of diverticulitis follow a low fibre diet and avoid foods that can irritate your bowel or that are not easily digested, e.g. fruit and vegetable skins, seeds and nuts. This diet will help to rest your bowels until the inflammation has reduced.

As your symptoms resolve you should gradually return to a normal diet and introduce fibre-containing foods. Make sure that you do not continue to avoid foods unnecessarily.

Foods suitable or to avoid on a low fibre diet

Starchy foods

Suitable foods

• White bread
• Corn or rice based breakfast cereal,e.g., Cornflakes, Rice Krispies, Frosties
• White pasta / rice, plain couscous
• Rice cakes and cream crackers
• Peeled potatoes, freshly cooked

Foods to Avoid

• Wholemeal, multigrain, granary, rye bread
• Wholegrain, wheat bran or oat based cereals,e.g., muesli
• Whole-wheat pasta, cold pasta dishes, brown rice, rice salad
• Ryvita, wholemeal crackers
• Skin on potatoes, potato salad

Biscuits, cakes and puddings

Suitable foods

• Plain and chocolate biscuits
• Plain cakes and puddings or pastries made with white flour
• Jelly, ice cream, milk puddings, rice pudding, semolina
• Chocolate

Foods to avoid

• Whole-wheat biscuits or those with dried fruit, nuts or seeds e.g., hobnobs, fig rolls
• Cakes made with wholemeal flour, oats, nuts, or dried fruit, e.g., fruit cake and flapjack
• Chocolate with fruit, nuts, or seeds

Meat, fish and alternatives

Suitable foods

• Soft tender meat and poultry
• Fish without bones
• Plain tofu, textured vegetable protein (TVP), Quorn

Foods to avoid

• Tough and gristly meat or skin
• Sausages and beef burgers
• Fish with bones and fish skin

Beans and pulses

Suitable foods

• Well-cooked and smooth pureed or mashed beans and lentils, e.g. hummus

Foods to avoid

• Beans and pulses with skins

Dairy foods

Suitable foods

• Milk, butter, margarine
• Most yoghurts

Foods to avoid

• Cheese containing dried fruit or nuts
• Yoghurts containing dried fruit or nuts

Spreads

Suitable foods

• Honey, syrup, seedless jam, smooth marmalade

Foods to avoid

• Jam with seeds and skin, marmalade with peel

Miscellaneous

Suitable foods

• Eggs, Oxo, Bovril, salt pepper, herbs, smooth condiments, e.g tomato ketchup

Foods to avoid

• Coconut, Pickles and chutney, grain mustard

Fruit and vegetables

Suitable foods

• Fruit juice
• Cooked or stewed fruit without skin
• Tinned pears, peaches, apricots
• Peeled fruit with seeds / pips removed, e.g. apples, plums, grapes,bananas
• Well-cooked vegetables with no stringy parts or stalks e.g., cauliflower / broccoli florets, spinach,sprouts, mushroom
• Skinned and deseeded cucumbers

Foods to avoid

• All dried fruit
• Berries, e.g., strawberries, raspberries, blueberries, blackcurrants, gooseberries
• Sweetcorn, broad beans, raw vegetables, e.g. peppers, radish, celery, cabbage, leeks, onions, lettuce and most salad leaves

When following the low fibre diet, try not to have more than two portions of fruit and two portions of vegetables per day (can be eaten in small amounts).

Contact us

For further information or to provide feedback:

St Richard’s Hospital

St Richard’s Hospital
Spitalfield Lane
Chichester, West Sussex
PO19 6SE

01243 831498

[email protected]

Worthing & Southlands Hospital

Southlands Hospital
Upper Shoreham Road
Shoreham-by-Sea
West Sussex
BN43 6QT

01903 286779

[email protected]

The information in this leaflet is for guidance purposes only and is in no way
intended to replace professional clinical advice by a qualified practitioner.