Diverticular disease encompasses both diverticulosis and diverticulitis. Each condition is different, as is the diet therapy prescribed. Healthcare professionals need to know the difference between the two disease states and need to be able to answer questions appropriately before the patient is discharged from the hospital.
Most women and men have small pouches in their colon which, as they get older, bulge out of weak areas of the colon. These bulging pouches are called diverticula and this condition is known as diverticulosis. Nearly fifty percent of Americans aged 60-80 have diverticulosis – almost everyone over 80 years of age has diverticulosis. When the pouches become infected, the condition is known as diverticulitis.
The cause of the infection of the small pouches is unknown. However, it is believed that diverticular disease is mainly caused by a low-fiber diet. Fiber is the part of fruits, vegetables and grains that the body cannot digest. Fiber gives food its crunch. When fiber is missing in the diet, the food is not able to move through the digestive tract as quickly and small particles of food can get caught in the small pouches of the colon, causing them to become infected.
A high-fiber diet is recommended with diverticular disease in order to keep the food moving through the body. A high-fiber diet helps reduce symptoms of diverticulosis and keeps stool soft so it is able to move easily through the colon. You can increase the amount of fiber in the diet by adding more 100% whole grain breads and cereals and fresh fruits and vegetables such as apples, melons, blueberries, broccoli, cabbage, spinach and dried beans. The American Dietetic Association recommends 20-30 grams of fiber daily to maintain bowel regularity.
Fiber and waste products from the GI tract are called residue (CareNotes system, n.d.). Once the small pouches become infected (diverticulitis), the dietary treatment changes to a low-residue diet in order to alleviate symptoms of the disease. Prior to discharge, healthcare professionals should provide survival skills to the patient, enabling him to function at home and to receive proper nutrition without causing further irritation.
Diverticulosis Survival Skills
- Choose fresh fruits and vegetables more often than juices.
- Choose whole grain breads such as 100% whole wheat, rye and bran.
- Choose cereals made from 100% whole grains such as wheat, bran or oats.
- Use brown or wild rice instead of white processed rice and in place of potatoes in meals.
- Use whole wheat flour instead of all-purpose white flour in recipes.
- Avoiding foods with nuts, seeds, or hulls may reduce the chances of food getting stuck in the diverticula.
- Use cooked lentils, dried peas and beans in casseroles, soups, etc. (Nutrition care manual, n.d.).
Diverticulitis Survival Skills
- Follow a low-residue diet. Fiber and waste products that remain in the GI tract after digestion are called residue.
- Limit dairy products like milk and cheese to 1-2 servings a day.
- Do not eat tough or stringy cuts of meat or deep fried foods.
- Do not eat raw vegetables or raw fruits that have skins or seeds (CareNotes system, n.d.).
- Avoid foods containing caraway seeds, nuts, popcorn hulls, and sunflower, pumpkin and sesame seeds (Nutrition care manual, n.d.).