Low-fiber and high-fiber diets both have a role in the treatment and prevention of diverticular disease. It all depends on the timing.
Q. I recently had a bout of diverticulitis. My doctor told me to eat a low-fiber diet, but I see lots of sources online saying that a high-fiber diet is recommended. Which is it?
Diverticulosis Versus Diverticulitis
Diverticulosis is a common and fairly benign condition where the large intestine develops small pouches or protrusions (called diverticula) along its inner walls. Lots of people have diverticulosis and don't even know it. But if stuff gets stuck in these pouches as it passes through the intestine, they can become infected. This infection, usually treated with antibiotics, is called diverticulitis.
A Low-Fiber Diet Helps Heal Diverticulitis
When diverticulitis first strikes, a low-fiber (or "low-residue") diet is often recommended to help your intestines recover from the inflammation and irritation. In very severe cases, which can require hospitalization, a patient might even be put on IV nutrition in order to give the intestines a complete rest.
A High-Fiber Diet Helps Prevent Diverticulitis
But once the infection has cleared up, a high-fiber diet can reduce the risk of future problems. When the time comes, I suggest increasing your fiber gradually to allow your system to adjust. Both soluble and insoluble fiber play a role in healthy bowel function, so try to incorporate a variety of fiber sources in your diet: fruits and vegetables (with their skins!), legumes, nuts, seeds, and whole grains.
No Need to Avoid Nuts and Seeds
Finally, people with diverticulosis used to be instructed to avoid things like popcorn, nuts, and seeds, on the assumption that these foods were more likely to become lodged in the pouches and cause infection. Fortunately, research has established that this is not the case--so feel free to enjoy these nutritious fiber-rich foods as part of your prevention plan.
See also: Nutrition Diva's Fiber Cheat Sheet
Popcorn exploding inside the packaging striped courtesy of Shutterstock