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Meticulous Medical Professional, Dr. Graham Gibb, Describes Diverticulitis – A Pain in The Gut

Originally posted on

Have you ever felt like you have somehow managed to swallow a shard of glass, and every time you make the slightest move you feel immense pain?  This is the sensation people experience during acute diverticulitis attacks.

Diverticular disease is a disease of the bowel or colon. Sections of the bowel distend and form pockets or pouches. These pockets, called diverticula, can catch small pieces of indigestible food as it travels through the bowel. If the food becomes stuck, infection is possible and can cause diverticulitis.

Patients who suffer from acute diverticulitis need antibiotics to help clear the infections. Some people even need to go into hospital for several days to receive IV antibiotics.

People who have experienced several severe attacks of diverticulitis may be eligible for re-section surgery, where surgeons cut out the affected section of the bowel and the bowel is re-joined. “As with any type of surgery, there are risks involved, but this operation can dramatically change the life of someone who suffers from many attacks,” stated Dr. Graham Gibb, a skilled general and colorectal surgeon.

Anyone who has experienced an attack of diverticulitis knows the tremendous pain it can cause. Even bending to tie up a shoelace can be absolute agony during an attack.

What you eat and drink can likely limit the impact of infections or attacks. Doctors recommend two distinct diets for people diagnosed with diverticular disease. One is for the majority of time and focuses on preventing acute attacks.  The other is for when you are experiencing an attack to ensure the healing process is as quick as possible.

While diet is a major factor in preventing attacks, it is not the only factor, and some patients have experienced an attack while following the diet strictly.

Diet for ‘Normal’ circumstances (No current attack)

People with diverticular disease will need to ensure all waste products can pass through the bowels without sticking in the diverticula (pockets in the colon). Doctors recommend a high fiber diet. Most people will eat about 20 grams of fiber per day. However, those with diverticular disease should eat about 40 to 45 grams of fiber per day.

Always drink plenty of water or fluids when on a high fiber diet. Fiber is from the indigestible parts of vegetables and fruits, and helps create bowel movements by absorbing water content and bulking up in the body. If you do not drink enough water on a high fiber diet, you may suffer from constipation.

High fiber foods include:

  • Whole grain or whole-meal breads
  • Cereals (particularly bran based cereal products)
  • Rye
  • Pears
  • Apples
  • Dried fruit (especially prunes, raisins, and apricots)
  • Beans
  • Lentils
  • Chickpeas
  • Vegetables (especially with the skin on)
  • Fruits.

This suggested day menu for a high fiber diet has 39.5 grams of fiber and allows for at least 8 cups of water or fluids.

FoodFiber Intake (g)Breakfast1/2 cup of baked beans with cheese62 whole-meal slices of toast51 cup of orange juice1Morning Snack1 orange or mandarin22 cups of water before lunch0Lunch2 wholegrain sandwiches (with vegetables, cheese or sandwich meat)8Cup of tea or coffee0Afternoon Snack2 wholegrain / whole-meal crackers with cheese42 cups of water before dinner0DinnerGrilled chicken breast in marinade0Whole-meal noodles21.5 cups (raw) stir fry vegetables including carrots, snow peas, peppers and green beans61 potato (with skin on)3.5Cup of water, tea or coffee0Dessert1 apple21 serving yogurt, or custard0Cup of water0TOTAL

Some doctors recommend avoiding small hard foods like nuts, seeds and corn kernels, as these are more likely to stick in the diverticula pockets. Try these foods carefully and learn to avoid any that cause you problems.

Diet for diverticulitis attack

Immediately after you feel the pains of an attack, start the antibiotics. This is the best way to fight the infection and heal quickly.

If you start to feel the sharp pains of acute diverticulitis, it is important to stop eating too much fiber. You need to give your bowels a rest, and hopefully a chance to expel the infected substance.  Fluids are essential at this point, and many doctors recommend drinking only clear fluids for a day or two.

Clear fluids include:

  • Water
  • Lemonade
  • Black tea or coffee (no milk)
  • Clear soup or broth

Once you have given your bowels a rest for a day or two on a clear fluid diet, you may like to try a full fluid diet. As well as the fluids above, you can have:

  • Milk
  • Yogurt
  • Creamy soups
  • Juices

You should try to have a full fluid diet for at least one full day after the attack begins.  Try a fluid diet for the first two or three days of an attack for best results.

You can now start to bring in other solids and foods to your diet. Choose bland foods, without too many spices, and foods that are easy to digest. You should have at least one meal that is mostly fluids on the first day of this part of the diet.

Suggested foods are:

  • Chicken
  • Noodles
  • Small amounts of fruit
  • Bananas
  • White bread
  • Fish
  • Mashed potatoes

Avoid red meats as these are more difficult to digest.

As you recover from your diverticulitis attack, you will find your appetite returns and you will be able to digest more types of food. Slowly, over the course of a few weeks, build your fiber content until you are eating your normal high fiber diet again.  

You should increase your fiber intake slowly, or your body will have difficulty in accepting the diet change. The following table suggests incremental increases in fiber over three weeks.

   Fiber Intake

Day       In grams120-22222-23322-23423-25523-25625-27725-27827-29927-291030-321130-321232-351332-351432-351532-351635-371735-371837-401937-402040 -452140-45

Diverticular disease is not always painful. Many people with the disease lead perfectly normal lives, with attacks occurring rarely or every few years. Others will have attacks of diverticulitis more often. Knowing the two distinct diet patterns will help you to manage your diverticular disease.

About Dr. Graham Gibb:

Dr. Graham Gibb has been a practicing surgeon for 18 years. He received specialized training in colorectal surgery from the University of Texas and completed his postgraduate work in general surgery in Calgary, Alberta. When he can get away from the hospital, Dr. Gibb loves taking advantage of his new pilot’s license and take in the beautiful scenery in Peterborough, Ontario.

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