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: diverticulosis vs. diverticulitis
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.
How to follow a diverticulosis diet
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:
- Whole grains.
- Legumes including lentils and nuts.
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:
- Drink at least 64 ounces of water a day – more if you’re active.
- Exercise regularly (it helps propel waste through your system).
- Eat a variety of food groups, including five or more servings of fruits and vegetables, three of whole grains and a serving of nuts or beans each day.
- Limit American diet favorites, such as red meat and processed and high-fat foods.
“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.”
How to follow a diverticulitis diet
“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.
Clear liquid diet for diverticulitis
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:
- Clear broths (not soup).
- Clear, pulp-free juices (such as apple and cranberry juice).
Low-fiber diet for diverticulitis
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:
- Grains: Lovers of white pasta and white bread, rejoice! Those are good low-fiber options, along with white rice and white crackers.
- Low-fiber starches: Get your peeler out. Potatoes without skin can be on the menu. Mash, roast or bake them. Certain low-fiber cereals also get a thumbs-up, including corn flakes and puffed rice cereal.
- Proteins: Choose eggs and egg whites, tofu, and meat or seafood. “It should be tender, so shredded chicken, lean ground beef and soft baked fish work best.”
- Fruits: Use caution since fruits have lots of fiber. Good options include canned fruits such as peaches or pears, applesauce, ripe bananas, and soft, ripe cantaloupe and honeydew. “It’s not a lot of fiber because you’re not eating the skin. The skins are the source of insoluble fiber, which can irritate inflamed polyps.”
- Dairy: “Cottage cheese and Greek yogurt are real winners if you’re recovering from a flare-up: They’re high in protein, calcium and other nutrients and don’t have any fiber. They’re also soft, moist and easier to get down if you’re not feeling well,” says Taylor. You can also have milk and cheese.
Foods to avoid with diverticulitis include high-fiber options such as:
- Whole grains.
- Fruits and vegetables with the skin and seeds.
- Nuts and seeds.
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.