So you’ve been diagnosed with diverticulitis, a form of diverticular disease. Eating and avoiding certain foods can help you manage and prevent symptoms — but there’s a lot of misinformation out there.
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The best diet for diverticular disease depends on whether you’re having a flare-up, says registered dietitian Anna Taylor, MS, RDN, LD.
Here, she clears up the confusion about how to manage diverticular disease with diet.
Diverticular disease means you have polyps (small growths) called diverticula in your gut. These polyps can exist without causing any symptoms and without you even knowing they’re there. This is called diverticulosis.
If the polyps become inflamed or infected, they can cause symptoms such as abdominal cramping, pain or tenderness in the area, swelling, bloating, constipation or diarrhea. This is called diverticulitis.
Constipation often contributes to the development of diverticula. “People develop polyps due to years of excessive muscular contractions as the body attempts to move small, hard stools,” explains Taylor. A high-fiber diet helps fight constipation by softening stool, which then moves through the GI tract more comfortably and easily. There’s also less pressure against the polyps, which prevents diverticulitis flare-ups.
To eat a diet rich in fiber (doctors recommend 25 to 35 grams per day), choose minimally processed plant foods such as:
Years ago, doctors thought that eating corn, popcorn, nuts and seeds could inflame the polyps and cause diverticulitis, but there’s no research to support that. “It’s safe to eat these types of foods, including tomatoes and strawberries with seeds,” Taylor notes. “All that normal roughage and fiber is fine.”
To get the most out of a high-fiber diet, Taylor also recommends:
“Diverticular disease may be common in Western societies because our diets are so low in fiber,” Taylor says. “Americans, on average, eat around 14 grams each day — about half of what’s recommended.”
“On the flip side, when you have diverticulitis, the polyps are upset, inflamed and maybe even infected. We want to reduce traffic in your GI tract so that nothing else irritates them,” says Taylor. “Decreasing the fiber in your diet helps with that.”
During a diverticulitis flare-up, your doctor may recommend rest, antibiotics and either a clear liquid or low-fiber diet.
If a diverticulitis flare-up is severe or requires surgery, your doctor may recommend a clear liquid diet. “After a day or two, you progress from clear liquids to a low-fiber diet,” says Taylor. “Even if your pain does not subside, you still move toward regular food. You can’t be on a liquid diet long-term because you can become malnourished.”
On a clear liquid diet, you can eat:
For milder cases of diverticulitis, eat a low-fiber, or GI soft, diet. A low-fiber diet limits fiber intake to between 8 and 12 grams of fiber, depending on the severity of the flare-up.
Good low-fiber food options include:
Foods to avoid with diverticulitis include high-fiber options such as:
Follow the low-fiber diet until diverticulitis symptoms subside. “Usually they start to improve after several days of being on antibiotics,” Taylor says.
If they do, your doctor will have you gradually increase your fiber intake over several days to weeks to avoid constipation and bloating. “The goal is getting back to a high-fiber diet to decrease your risk for future bouts of diverticulitis,” Taylor adds. “But if you’re not feeling better within a few days, talk to your doctor.”
Talk to your doctor about a long-term plan, too. And if you’ve recently been diagnosed with diverticular disease, meet with a dietitian to learn practical and sustainable ways to get more fiber into your diet. “Dietitians can also give you more specific recommendations to feel better during a diverticulitis flare-up,” Taylor says.