Digestive Health Center Nutrition Services

Low Fiber Diet for Diverticulitis
Diverticulosis in the colon is where segments of the colon pushes out into pouches called diverticula. Diverticulitis occurs when the diverticula becomes inflamed and/or infected. A flare of diverticulitis can occur suddenly with abdominal pain usually arising in the lower left abdomen; fever, nausea, vomiting may also be present. Fiber is a component of complex carbohydrates that the body cannot digest, is found in plant based foods such as fruits, vegetables, whole grains, etc. Fiber promotes regular bowel movements and keeps stools soft and bulky. When there is not enough fiber in the diet, stools become hard and could be difficult to pass through the colon. This puts pressure on the walls of the colon, which then may give out to form diverticula. While a diet high in fiber may help prevent diverticulosis and thus diverticulitis; a diet low in fiber may help reduce GI discomfort during flares of diverticulitis by reducing frequency of stools. While with Diverticulitis: Follow a low fiber diet (usually 10-15 grams of fiber per day) until your flares subside. Once symptoms resolve, gradually add high fiber foods one by one back into the diet (goal is to reach 30-35 grams of fiber per day). It may help to limit the following foods ONLY IF you have problems with diarrhea (may occur from infection or inflammation in the colon) and/or have gas, bloating, cramping. o Foods that are greasy, fried and sugary o Dairy with high amounts of lactose (the milk sugar in dairy) o Sweetened and caffeinated beverages: smoothies, sugary fruit juices, sodas, lattes, etc o Foods sweetened with isomalt, mannitol, sorbitol, xylitol (artificial sweeteners) Also... Eat small frequent meals throughout the day (4-6 meals/day). Aim to always include multiple food groups at each meal for a well balanced diet.

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Foods To Eat Meats, Fish, baked, broiled, grilled or steamed Poultry, Eggs meats/poultry/fish, deli slices, eggs Dairy lactose free dairy (any) low lactose dairy: cream cheese, half and half, hard cheeses (cheddar, colby, parmesan, swiss, etc), soft cheeses (feta, mozzarella, etc), yogurt (greek)

Foods to Limit fried meats/poultry/fish/eggs high lactose dairy (large amounts): buttermilk, chocolate, creamy/cheesy sauces, custard, ice cream, milk (cow's, goat's, sheep's, condensed, evaporated), soft cheeses (cottage, ricotta, etc), sour cream

Meat, Dairy Alternatives Grains

milk alternatives (almond, coconut, rice, beans, black eyed peas, lentils, nuts, soy), creamy nut butters, tofu crunchy nut butters, fried tofu, soybeans, split peas, soy/bean patties made with refined wheat, made with foods allowed: bagels, biscuits, breads (french, italian, pita, white, sourdough), cereals (cream of wheat, cream of rice, oatmeal, cornflakes, Cheerios, Chex, Rice Krispies, etc), chips, crackers (graham, saltine, soda, etc), English muffins, flour tortillas, noodles, pancakes, pastas, pretzels, tapioca, waffles, white rice applesauce, avocado, banana, canned fruits (drain the syrup), lemon, lime, melons, peeled: apple, apricot, peach, pear, peach, plum, etc, fruit puree/sauces (any, no pulp, no skins) cooked (no pulp, no skins): beets, carrots, green beans, potatoes, pumpkin, spinach, squash, wax beans, yams, zucchini, etc, vegetable/tomato puree/sauces (any, no pulp, no skins) decaf coffee, fruit and vegetable juices/smoothies (any, small amounts, no pulp or skins), sport drinks, tea angel food cake, chocolate (small amounts), marshmallows, sugar free desserts (puddings, popsicles, etc) broth, butter, cooking oils, all spices and herbs, gravy, honey, jam/jelly, ketchup, margarine, mayonnaise, mustard, pepper, salad dressings, sauces (BBQ, soy, etc), salt, vinegar
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made with whole wheat or made with foods to limit, barley, bran, breads (multi grain), bulgur, corn tortilla, croissants, high fiber cereals (Kashi, Fiber One, etc), granola, popcorn, quinoa, rice (brown, wild), rye, sugary cereals (Fruit Loops, etc), sweet rolls

Fruits

dried fruits, fruit seeds/skins, fried fruits, berries, cherries, dates, figs, grapes, grapefruit, guava, kiwi, mango, papaya, persimmon, pineapple, pomegranate, prunes, orange raw vegetables, fried vegetables, vegetable seeds/skins, artichokes, asparagus, broccoli, brussel sprouts, cabbage, cauliflower, celery, corn, cucumbers, eggplant, green peas, lettuce, mushrooms, okra, tomatoes caffeinated coffee, lattes, sodas, prune juice fried desserts, brownies, cakes, caramel, candy, cookies, donuts, pastries, pies, sherbet, sorbet coconut, maple syrup, olives, pickles, sugar (large amounts), jam/jelly with seeds, all seeds (flax, sunflower, etc), artificial sweeteners (isomalt, mannitol, sorbitol, xylitol)

Vegetables

Beverages

Desserts

Seasonings, Condiments

Sample 1 Day Menu: Meal Food Choices Breakfast 1 scrambled egg 1 slice sourdough toast with 1 teaspoon margarine ½ cup cream of wheat ½ cup cranberry juice Tea or coffee ½ cup canned fruit cocktail (in juice) 1 cup low fat milk Tuna sandwich on white bread (3 TBSP tuna salad, two slices bread) 1 cup cream of chicken soup 6 saltine crackers Water Tea or coffee ½ cup greek yogurt 1 cup cut up cantaloupe cubes Water 3 oz chicken breast 1 cup white rice ½ cup cooked carrots 1 TBSP margarine 1 soft, white dinner roll Tea or coffee

Snack Lunch

Snack

Dinner

Approximate Nutrition Analysis: Calories: 1,670 kcal Protein: 100 grams (24% of calories) Carbohydrate: 207 grams (50% of calories) Fat: 46 grams (25% of calories) Cholesterol: 358 mg Sodium: 3,230 mg Fiber: 10 grams

Resources: "Low Residue Diet in Diverticular Disease: Putting an End to a Myth" Nutrition in Clinical Practice April 2011 "Diverticular Disease: Evidence for Dietary Intervention?" Nutrition Issues in Gastroenterology (in Journal of Practical Gastroenterology) February 2007 "Fiber Content of Foods" Nutrition Care Manual from the Academy of Nutrition and Dietetics Not for reproduction or publication without permission Direct inquiries to Digestive Health Center at Stanford Hospital and Clinics 3

NS 1/2014