You may have been referred to the Dietetic Department for dietary advice related to Diverticular Disease.
As you are aware the NHS is currently under immense pressure due to the current COVID 19 pandemic. During this period we are not able to provide our usual service as we need to prioritise to reduce the risk to our patients. In view of this, we unfortunately are unable to offer you an appointment in our Dietetic clinic. Should the national position change we will be able to resume our service as normal and you can self-refer back into our service. In the meantime we hope that the following information will help you self-manage your condition.
Diverticular Disease is a condition that affects the large bowel (Colon), where small bulges develop in the lining of this area of the bowel.
Most people with this condition have few or no symptoms. However, some may develop inflammation or Diverticulitis, which is the term used to describe an infection that occurs when bacteria becomes trapped inside one of the bulges, triggering severe symptoms.
Diet and uncomplicated Diverticular Disease
If you are symptom free with your Diverticular Disease, eating the recommended daily amounts of fibre in your diet may help to prevent further problems. If your diet is low in fibre, as part of a balanced diet, you can include some high fibre foods. Try to include 5 portions of fruit and vegetables a day. These can be fresh, frozen, tinned or dried.
Although there is limited evidence it is suggested care may be taken with pips and skins of fruit and sweetcorn, nuts, seeds, as these could become trapped in small bulges which may be present in your large bowel.
To prevent the side effects associated with a high fibre diet, such as wind and bloating, it is recommended that you gradually introduce these foods over a few weeks. Constipation may occur from a high fibre diet without enough fluid, therefore drink plenty of fluid – at least 6-8 cups or glasses per day of water, tea, coffee, squash, and fruit juice etc.
Low Fibre diet to manage Diverticular Disease with symptoms
Traditionally, patients with Diverticular Disease have been advised to follow a high fibre diet to manage their symptoms. However, if you are experiencing symptoms, particularly diarrhoea and bloating, a low fibre diet may help to rest the bowel and prevent further symptoms or exacerbation of problems.
A low fibre diet involves avoiding foods which are high in fibre, but other foods can be included. If there is no improvement or your symptoms worsen, discontinue the low fibre diet, return to your normal diet. Once your symptoms start to improve you may gradually reintroduce fibre to find your tolerance level. Herbs and spices should be used with caution. Certain ones may aggravate your symptoms and therefore should be avoided.
The following table shows foods high in fibre and a low fibre alternative. If you are not experiencing symptoms you may include foods high in fibre; if you are symptomatic only choose foods low in fibre.
| Food | High Fibre Choice | Low Fibre Alternative |
|---|---|---|
| Bread, pitta, chapatti, rolls | Brown, granary, seeded, wholemeal, No. 2 or No. 3 flour | White |
| Potato | With skin | Remove skin |
| Pasta | Wholemeal | White |
| Rice | Brown | White |
| Biscuits | Containing oats, dried fruit, Ryvita, Oatcakes, Digestives, flapjacks, crackers containing seeds | Shortbread, wafers, creams, Rich Tea, Cream Crackers, water biscuits |
| Desserts | Scone with dried fruit, fruit pie, carrot cake, sponge cake with nuts or fruit, fruit crumble coconut cake. | Jelly, milk pudding, smooth yoghurt, ice cream, custard, instant whip, mousse, plain scone, plain sponge cake |
| Dairy | Cheese containing dried fruit, Yoghurt with fruit pieces, cottage cheese containing fruit or vegetables | Hard & soft cheese, cream, Greek or natural yoghurt, smooth fruit yoghurt, milk, fromage frais, plain cottage cheese |
| Meat, fish alternatives | Casseroles containing vegetables, lentils, chickpeas, beans, Meat or fish coated in wholemeal breadcrumbs or flour, nuts, hummus | Soya, Quorn, Fish, eggs, poultry, meat, fish coated in white breadcrumbs or batter, meat pie made with white flour |
| Food | High Fibre Choice | Low Fibre Alternative |
|---|---|---|
| Cereal | Porridge, Weetabix, Muesli, Granola, Shredded Wheat, All Bran, those containing fruit or nuts | Cornflakes, Rice Krispies, Frosties |
| Vegetables | Peas, cabbage, spinach, asparagus, Brussels sprouts, parsnips, celery leeks, onions, sweetcorn, mushrooms, peppers, sweet potato, green beans, raw carrot | Softly cooked broccoli or cauliflower, aubergine, swede, turnip, cucumber, iceberg lettuce, boiled carrots, marrow, tomato puree, pumpkin, skinned & seeded tomatoes |
| Fruit | Apples, pears, strawberries, kiwi, oranges, raspberries, nectarine, pineapple, pomegranate, peaches, prunes, raisins, passion fruit, gooseberries, blueberries, avocado | Banana, 6 x seedless grapes, melon, stewed plum, stewed apple, tinned pineapple, tinned apricot, tinned peaches, tinned mandarins, tinned grapefruit, stewed cherries, tinned mango |
| Drinks | Fruit juice with pith, fruit or vegetable smoothies, milk shake with real fruit or seeds | Tea, coffee, hot chocolate, malted milk, milk, alcohol, milkshake syrup, fizzy drinks, concentrated squash |
| Miscelleneous | Coleslaw, pickles, peanut butter, sweet mincemeat, jam with seeds, marmalade with peel, popcorn, nuts & seeds, chocolate fudge or toffee containing fruit or nuts, packet or tinned soups containing vegetables, canned sauces containing fruit or vegetables | Marmite, clear or cream soups, Oxo, Bovril, stock cubes, gravy, cheese sauce, white sauce, lemon curd, smooth jam or marmalade, butter, margarine, potato or corn crisps, boiled sweets, chewing gum, milk or plain chocolate, fudge or toffee |