HIGH FIBER DIET FOR DIVERTICULAR DISEASE

Purpose: To provide a diet with 20 to 35 grams of appropriate fiber to promote regular elimination and increases fecal excretion.     

Use: This diet can be used for the management of diverticulosis. The rationale for the increased fiber is that the increased bulk in the stool reduces the pressure in the colon, thus preventing further diverticula from forming.

Diverticulosis (the condition) and diverticulitis (the inflammation) are also called diverticular disease (notice the difference in endings, “itis” vs “osis”).  Diverticula (the underlying cause of diverticula is constipation: the pressure of straining produces pouches in the colon) are tiny pea-shaped pouches of weakness in the wall of the large intestine.  This condition is called diverticulosis and is usually symptom-free. Most people do not realize they have it. However, for a few people, diverticulosis results in spasms and pain.

If the diverticuli become inflamed, infected or ruptured, the condition is called diverticulitis.   In other words, a person with diverticulosis may get diverticulitis when waste matter is trapped in a pouch and then becomes inflamed or infected. Diverticulitis can result in fever, pain and tenderness around the left side of the lower abdomen and may require surgery.

The two major signs of diverticular disease are bleeding and infection.
 

THE HIGH FIBER DIET

Studies have shown that a balanced diet containing different kinds of fiber can help regulate the bowels, aid in the prevention of heart disease and protect against a number of other health problems such as diverticulosis. Another way fiber contributes to good health is by helping to protect against cancer of the colon and rectum. Foods that contain fiber also tend to contain other cancer fighting nutrients, such as vitamin A, vitamin C, vitamin E and selenium.

Dietary Guidelines

·         Many people have the misconception they must avoid tiny seeds, grains, lettuce, and other high fiber containing foods for fear that the particles could lodge in the diverticula and cause inflammation.  This has never been proven and in fact microscopic review of surgical specimens show this to not be the case. There is no reason to avoid such foods for fear they will precipitate disaster.

·         Foods such as nuts, popcorn hulls, and sunflower, pumpkin, caraway, and sesame seeds should be avoided.

·         People differ in the amounts and types of foods they can eat. Decisions about diet should be made based on what works best for each person.

·         Scan food labels for bread and cereal products listing whole grain or whole wheat as the first ingredient.

·         Look for cooked and ready to eat cereals with at least 3 grams of fiber per serving.

·         Eat raw fruits and vegetables; they have more fiber than cooked or canned foods, or juice. Dried fruits (especially dried figs) are also good sources of fiber.

·         Increase fiber in meat dishes by adding pinto beans, kidney beans, black-eyed peas, bran, or oatmeal.

·         Try adding 2-3 tsp. of unprocessed wheat bran to foods such as meatloaf, casseroles, homemade breads, muffins and other baked goods.

·         Dairy foods provide little fiber. Increase fiber by adding fresh fruit, whole grain or bran cereals to yogurt or cottage cheese.

·         Chopping, peeling, cooking, pureeing, and processing may reduce fiber content

·         Substitute oat bran for one third of all-purpose flour in baked goods recipes.

·         Best to eat a variety of foods and not to rely on a fiber supplement

·         Do it gradually—rapid fiber increase may result in gas, cramping, bloating, or diarrhea.

·         Drink plenty of fluids - A high-fiber diet requires lots of liquids. Fiber acts as a sponge in your large intestine - if you don't drink enough, you could become constipated. Try for at least 6 cups daily.

HIGH FIBER DIET

BREADS & GRAINS 6-11 servings each day

• Bread, pastas, pizzas, pancakes, muffins, bagels, pita bread and muffins made with whole-grain flours
• Whole-wheat and other whole-grain cereal products
• Buckwheat and stone-ground cornmeal
• Rye bread
• Whole wheat crackers or crisp breads
• Whole grain or bran cereals (Excellent high fiber choices are Bran Buds and All-Bran, but 100% Bran, Raisin Bran, Most and Cracklin' Bran are also excellent sources)
• Oatmeal, oat bran, or grits
• Barley, dry
• Wheat germ
• Whole wheat pasta
• Brown rice

VEGETABLES 3-5 servings each day

All vegetables such as asparagus, broccoli, Brussels sprouts, cabbage, carrots, Greens such as beet greens, kale, collards, Swiss chard and turnip greens, green beans, green pepper, onions, peas, potatoes with skin, Romaine, snow peas, green snap beans, pole beans, broad beans, spinach, squash, sweet potatoes, turnips

The seeds in tomatoes, zucchini, cucumbers, as well as poppy seeds, are generally considered harmless

FRUIT 2-4 servings each day

All fruits such as apple, apricot, banana, blackberries, blueberries, cherries, dates, fig, grapefruit, nectarine, orange, peach, pear, pineapple, prune

The seeds in strawberries and raspberries are generally considered harmless

MILK & DAIRY 2-3 servings each day

All

MEAT & MEAT SUBSTITUTES 2-3 servings or total of 6 oz daily

• All beans and peas such as aduki, garbanzo beans, black beans, baked beans, kidney beans, fava, lentils, lima beans, split peas, and pinto beans
• Smooth peanut butter and other smooth nut butters
• All meat, poultry, fish, and eggs

The seeds in poppy seeds are generally considered harmless

FATS & SNACKS

• Whole-wheat pretzels, baked tortilla corn chips or trail mix made with dried fruits
• Cakes, breads, and cookies made with oatmeal or fruit
• Bean dip