Definitions
- Diverticulosis: Outpouchings in the colon wall; often asymptomatic; prevalence rises with age.
- Diverticulitis: Inflammation/infection of diverticula; causes LLQ abdominal pain, fever, elevated WBC; may include nausea, bowel changes.
Diagnosis
- Diverticulitis: Clinical exam + CT abdomen/pelvis with contrast for confirmation/complications (abscess, perforation).
- Post-episode: Colonoscopy 6–8 weeks later (if not up-to-date) to exclude other pathology after recovery.
Diet by Stage
- Acute uncomplicated diverticulitis:
- Initial: Clear liquids 24–48 hours if advised; advance as tolerated.
- Transition: Low-fiber, low-residue foods (white rice, potatoes without skin, eggs, yogurt) until pain resolves.
- Recovery: Gradual fiber reintroduction over 1–2 weeks.
- Complicated disease (abscess/perforation): Hospital care, antibiotics, drainage/surgery as indicated.
- Diverticulosis (maintenance):
- High-fiber pattern (goal 25–35g/day) with gradual build: fruits/veg, oats, legumes (tolerance-based), whole grains.
- Adequate hydration, regular physical activity.
Historical myth:
- Nuts, seeds, corn are generally safe; focus on overall fiber quality and stool regularity rather than blanket avoidance.
Flare Prevention
- Daily fiber habit + water.
- Maintain healthy weight; avoid smoking.
- Limit frequent NSAID use if possible (discuss alternatives).
- Physical activity (especially vigorous) correlates with lower risk.
- Address constipation early (psyllium/PHGG, fluids, movement).
When to seek care:
- Fever, escalating pain, persistent vomiting, inability to advance diet, rectal bleeding, or recurrent episodes.
