The best diverticulitis diet: 7 foods to eat and 8 to avoid

In this article:

• How to manage diverticulitis with diet
• Foods to eat to prevent a flare-up
• Foods to eat during a flare-up
• Foods to avoid
• When to see a healthcare provider

In this article

• How to manage diverticulitis with diet
• Foods to eat to prevent a flare-up
• Foods to eat during a flare-up
• Foods to avoid
• When to see a healthcare provider

Pockets are all the rage in fashion these days, but pockets in your colon can cause some serious problems—namely, diverticulitis, a painful medical condition that occurs when these small pockets, called diverticula, become inflamed or infected.

To be clear, many Americans (especially those older than 50) develop these small pouches in their colon wall; this is called diverticulosis or diverticular disease, and it usually isn’t a serious condition. You can have diverticula and never experience inflammation or infection. In fact, most people with diverticulosis will not experience problems. The two complications that can occur with diverticulosis are diverticular bleeding and diverticulitis—and these acute attacks, or flare-ups, are not only painful but can be dangerous if left untreated. 

Figuring out what causes diverticulitis for you, personally, is the most important thing you can do to manage your condition and avoid flare-ups…but you might not be aware yet of what your triggers are. Here are the foods generally considered safe and unsafe to eat—as well as how else you can manage your diverticulitis. 

How to manage diverticulitis with diet

While newly diagnosed people often feel overwhelmed by the limitations of a diverticulitis diet, the good news is that you don’t need to be overly restrictive with what you eat or follow a special diet long-term. There are a few “golden rules” when it comes to choosing safe foods for diverticulitis that can make it easy to keep your digestive system happy.

Know your triggers 

Each person with diverticulitis needs to base their diet around their own particular circumstances, according to Kathryn A. Boling, MD, primary care provider with Mercy Personal Physicians at Lutherville in Maryland. What bothers you might not bother someone else with diverticulitis; on the flip side, you might be able to eat foods that many other people can’t.

“Across populations, studies say you don’t have to worry about what you eat [normally], but patients often say to me, ‘I know we can eat whatever we want, but I’ve noticed things like nuts or popcorn cause problems for me,’” Dr. Boling says.

FYI, Dr. Boling suffers from diverticulitis herself…and her biggest trigger is blackberries. If something triggers your symptoms, avoid eating it even if it doesn’t go against “the rules.” 

Take it slow 

If you’ve recently had a diverticulitis attack and are getting back to eating normally again, it’s important to ease into your usual diet. This is especially important if you don’t know what caused your flare-up; otherwise, you run the risk of eating the exact thing that triggered your symptoms in the first place. You may then have to start all over again. It is also recommended to initially eat a low-fiber diet during and immediately after a bout of diverticulitis. Examples of low-fiber foods include white bread, white rice, and white potatoes. Long-term, a diet full of fiber-rich foods is recommended.

Try a Low-FODMAP or BRAT diet

The low-FODMAP diet, which focuses on reducing fermentable carbohydrates that can cause gas, can be particularly helpful during diverticulitis flare-ups that cause bloating and abdominal pain. By eliminating foods high in FODMAPs—such as certain fruits, vegetables, legumes, and dairy products—you may experience relief from uncomfortable digestive symptoms. Once the flare ends and inflammation decreases, try slowly reintroducing these foods to identify your personal triggers.

The BRAT diet, which consists of bananas, rice, applesauce, and toast, can give your digestive system a rest during a flare-up. These easily digestible foods help stabilize bowel movements and reduce intestinal irritation. The BRAT diet should only be followed for a short period until symptoms improve, because it doesn’t provide the nutrients you need over the long-term.

Understand how to manage attacks

“What you eat when you have an acute attack is different than what you eat when you’re better,” explains Dr. Boling, who adds that during an attack, you should stay away from any hard-to-digest foods and foods that pass through your GI system quickly (such as raw veggies and roughage).

On the other hand, if you’re not having an attack, it’s okay to eat any foods you know are not a trigger for you.

7 foods to eat to prevent a flare-up

The American Gastroenterology Association recommends that patients who have experienced a prior diverticulitis attack consume a high-fiber diet to avoid future flare-ups. Keep in mind that this list is subjective, and something here may be a trigger for you. But in general, these foods tend to be easy on the intestines of people with diverticulitis.

1. Whole-grain carbohydrates: If low-fiber cereals and rice are difficult for you to digest, try instant oatmeal, whole wheat pasta or noodles, and whole-grain bread, muffins, or wraps. 
2. Lean protein: Eggs and tender cuts of meat (think shredded chicken, baked fish, and ground beef) are usually easy to digest.
3. Cooked fruits and vegetables: If you believe the skin of fruits has caused irritation in the past, you may need to remove it.
4. Starchy foods, like potatoes: A diet high in starch is friendly to your colon (however, you may consider peeling the potatoes first).
5. Juice, tea, and water: Choose pulp-free juices (apple, grape, or cranberry instead of orange) that won’t irritate your colon.
6. Beans and legumes: Beans and legumes, such as lentils, chickpeas, and kidney beans, are high in fiber, which reduces constipation and improves digestive function.
7. Probiotic-rich foods: Probiotic-rich foods, like kimchi, kefir, yogurt, kombucha, and sauerkraut, can reduce the risk of diverticulitis flare-ups by enhancing digestive health. 

What to eat during a diverticulitis flare-up

When you’re in the middle of a flare, changing up your diet to “baby” your gut allows it to rest and heal. Once the flare is under control, you can return to normal eating habits.

Symptoms of a diverticulitis flare-up include:

• Pain, often on your lower left side
• Nausea and vomiting
• Cramping and bloating
• Fever
• Diarrhea or constipation

Liquid diet for diverticulitis flare-ups

If you’re experiencing an acute diverticulitis attack and want to rest your bowel so it can recover faster, you might want to go on a clear liquid diet for one to two days, advises Dr. Boling. In other words, if you can see through it, you can eat or drink it. This type of short-term diet can be used to recover from an acute attack, to preempt an oncoming attack (when you start to feel symptoms), and even alongside antibiotics, should your healthcare provider prescribe them.

While waiting for your flare to resolve, you can consume clear liquids, including:

• Clear broths
• Water or ice chips 
• Clear sports drinks
• Ice pops
• No-pulp fruit juices
• Vegetable juices
• Herbal tea
• Gelatin (since it’s digested as a liquid) 

Low-fiber diet for diverticulitis flare-ups

A low-fiber diet can be beneficial during a flare-up, allowing the inflamed colon to rest and heal. High-fiber foods (which are good for preventing flares) can actually worsen symptoms in an acute flare by adding bulk to the stool and causing bloating, leading to more discomfort. 

These easily digestible, low-fiber options are gentle on the digestive tract and can help promote healing:

• White rice
• Plain pasta
• Applesauce
• Ripe bananas
• Canned fruits (without skin)
• Cooked carrots
• Mashed potatoes (without skin)
• Eggs
• Lean chicken or turkey (without skin)
• Baked or broiled fish
• Smooth peanut butter

Once the flare is under control, you can return to normal eating habits.

8 foods to avoid

In the past, physicians used to recommend that patients with diverticulitis avoid all nuts, seeds, and corn products, but healthcare providers know now that those restrictions don’t need to be applied to all patients. Many people are able to eat these foods without issue.

You may be able to eat these foods whenever you want, eat them carefully or infrequently, or eat them in small amounts—or they may pose too much of a trigger for your colon. If that’s the case, you’re in good company; these are the foods that could potentially cause a diverticulitis flare-up.

1. Hard-to-chew foods: Hard foods that are difficult to break down are more likely to get trapped in the pockets of your colon. 
2. Medium-sized seeds or nuts: Sunflower seeds, for example, may be difficult on your digestion; strawberry seeds usually aren’t (though they could still bother you!).
3. Popcorn and corn on the cob: Because you tend to eat these foods quickly—rather than taking time to fully chew them—they are more likely to cause issues.
4. Red meat: Some studies suggest red meat can contribute to diverticulitis flares. One such study showed an increase in attacks for men who consumed more red meat than other types of protein, like poultry and fish.
5. High-FODMAP foods: Some experts think following a low-FODMAP diet can reduce the amount of pressure in the colon and limit the number of acute attacks a person with diverticulitis might have.
6. Spicy foods: Foods with a lot of heat can irritate the digestive tract and exacerbate symptoms during a flare-up.
7. Processed foods: Items such as frozen meals, snack foods, and fast food often contain additives and preservatives that can be hard on your digestive system.
8. Refined grains: Foods made with white flour, such as white bread and pastries, lack fiber and can contribute to digestive issues, making them less ideal for those with diverticulitis (except during a flare!). Instead, focus on foods like whole wheat bread, brown rice, and quinoa. 

Are alcohol and coffee bad for diverticulitis? 

Not necessarily, though you definitely want to avoid alcohol and caffeine if you’re experiencing a diverticulitis attack.

“Coffee is a bowel stimulant, so if you’re having an attack, you might want to stay away and rest your bowel,” says Dr. Boling, “but in the long run, people who have recovered can drink it.”

The same goes for alcohol, though Dr. Boling does warn that alcohol is hard on your stomach in general—and symptoms of other health conditions, like pancreatitis, can be similar to symptoms of a diverticulitis flare (making it hard to know if you’re treating your symptoms appropriately).

When to see your provider 

If you’re experiencing an acute attack, you can try resting your bowel with a clear liquid diet for one to two days, says Dr. Boling, but if you’re still having pain after that, you should contact a healthcare professional. In addition, fevers, severe abdominal pain, or vomiting should prompt urgent medical attention.

Don’t ignore your symptoms or brush them off as “just diverticulitis,” she notes. You may need antibiotics, IV hydration, or even hospitalization to feel better. In worst-case scenarios, diverticulitis can become fatal if left untreated (thanks to the risk of a perforated bowel and sepsis).