You’ve recently been told you have diverticulitis. So what is it and what can you do to reduce further episodes of ‘diverticulitis’
Diverticulitis is inflammation of the diverticular.
Diverticular are out pouchings of the large intestine ( colon) where digested food can become trapped. Not everyone has diverticular or diverticulosis but 1 in 3 in the developed world do, so you are not alone .
Have a look at this image from the charity GUT UK:

Its more common in the developed world due to our diet; which is LOW in fibre as many do not eat whole foods, or eat enough fruit or veg, and sorry to say for those meat lovers, eat too much processed meat or red meat.
Evidence is now highlighting that it is also a consequence of our sedentary less active lifestyles with office based desk jobs, and screens and TVs as hobbies . Other risk factors include smoking, disruption of the gut microbiome with poor diet and recurrent antibiotic use, alcohol and ultraprocessed foods as well as obesity .
The great news is that the evidence has changed and it is now not thought to be a progressive disease and there is lots you can do to prevent a further flare and reduce your gut inflammation.
Below I highlight the key points from the medical literature, so you know how to adapt your lifestyle to manage your condition.
There is a lot you can do, meaning you can retake control of your health one step at a time.
For long term health I always suggest starting with one goal and try sticking at it for 3 weeks before adding in a new goal. Using a journal to track your progress and remind you when to start working on the next goal.
There are 12 LIFESTYLE factors that can reduce your incidence of a diverticulitis flare. If you needed to work on all 12 and you worked consistantly using this approach of a goal every 3 weeks, the lifestyle changes would take 33 weeks. Long term health means long term , life long changes. I can support you with individual health coaching if you feel this would benefit you, but otherwise consider the LIFESTYLE factors below and choose just 1 to start with ( it does not need to be number 1) .
The evidence is clear and my goal is to share with you EVIDENCE based MEDICINE so you can make informed choices
Lifestyle Changes to Reduce your chance of a flare of diverticulitis:
1) Optimise your gut microbiome – there is NO good evidence for probiotics for diverticulosis or diverticulitis therefore save your money. Instead feed your gut microbiome by eating a variety of ‘pre biotics’ ( whole plants of different colours – grains, nuts, seeds, leaves, plants, fruits, pulses, lentils & fermented foods to improve the diversity of your gut microbiome which will reduce gut inflammation. There is no need to avoid seeds, nuts, popcorn or fruit skins – these are all great sources of FIBRE !!!
2) Reduce your RED meat consumption and STOP all processed meat ( ham, salami, sausage, bacon, chorizo - the WHO classifies processed meat as a class 1 carcinogen)
3) Increase your intake of fibre with ‘WHOLE FOODS’ – this means; 'does it look like its original form' – ie an apple looks like an apple but apple juice does not look anything like an apple ( ie it wont have fibre in it & has very little health benefit just costs you a fair amount)
4) Choose WATER as your drink of choice and AVOID ‘diet’ drinks or fizzy drinks. Aim for 8-10 glasses of water a day approx. 2 L.
5) Exercise regularly including at least 2 hours of intense exercise per week
6) Reduce your saturated fat intake ( animal fat and coconut & palm oil)
7) Reduce your refined carbohydrates – white flour based products and choose whole grains
8) STOP smoking
9) Loose weight aiming for your BMI to be < 25 but any reduction if you are overweight is great – remember small steps and I can support you on how to loose weight and keep it off according to all the evidence – its not a quick fix its choosing a whole food plant predominant diet with some careful consideration of your individual health needs
10) Reduce your reliance on NSAIDS – ibuprofen and naproxen (anti-inflammatory medications) by adopting lifestyle changes as these medications increase the risk of flares and complications of diverticulitis.
11) Optimise your vitamin D levels ( the sunshine vitamin) by ensuring you take 10mcg ( 400iu) per day from October to April or even year round (if you are not an out doorsey person) Patients with low vitamin D have been shown to have a higher risk of diverticulitis and recurrent flares .
12) Limit or avoid alcohol
Great resources for you to look at that are reliable and evidence based include ;
GUTScharity
British Dietary Association
The Eatwell Guide

Please remmebr if you have a change in bowel habit or unexplainned abdominal pain with or without blood in your stool speak to your GP .
Finally if you have a colonoscopy that shows diverticulosis it does not mean you have diverticular disease. Diverticular disease is when you have symptoms such as pain, wind, malaise , temperature and signs of inflammation or infection. You may never develop these symptoms, but to reduce your risk optimise your bowel and whoel health with the 12 TIPS above. Your GP / doctor may wish to do a blood test to look for active inflammation or infection if they suspect you are having a flare of 'diverticulitis' to help decide on the best treatment. Most cases DO NOT require antibiotics. If you have pain and are unwell make a GP / doctor appointment to discuss your managment. Limiting FIBRE and choosing a liquid easily digestible diet during a flare allows your gut to heal more quickly.
Your blood tests may show a raised inflammatory marker (CRP). Your CRP may be greater than 100mg/L in an acute flare of diverticulitis. Your GP / doctor may also ask you to have a full blood count ( FBC) and perform a qFIT ( poo tests) to check your stool for blood that you cannot see. The qFIT test (faecal immunochemical test) if positive would result in an URGENT colonscopy on the NHS 2 weekwait programme to exclude bowel cancer.
Great recipe ideas can be found at:
I love their 'spinach and butter bean curry https://thehappypear.ie/general/low-fodmap-spinach-and-butterbean-curry-recipe/
Or try a simple bolognase or chilli with NO red meat; my kids and husband all love and didnt realise it was meat free when we all went plant based over 5 years ago now; the BOSH ULTIMATE CHILLI https://www.bosh.tv/recipes/ultimate-chilli
Reference papers for your info ;
Cao Y, Strate LL, Keeley BR, et al. Meat intake and risk of diverticulitis among men. Gut 2017.
Strate LL, Keeley BR, Cao Y, et al. Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study. Gastroenterology 2017;152:1023–1030
Hjern F, Wolk A, Hakansson N. Obesity, physical inactivity, and colonic diverticular disease requiring hospitalization in women: a prospective cohort study. Am J Gastroenterol 2012;107:296–302
Rosemar A, Angeras U, Rosengren A. Body Mass Index and Diverticular Disease: A 28-Year Follow-Up Study in Men. Dis Colon Rectum 2007
Hjern F, Wolk A, Hakansson N. Smoking and the risk of diverticular disease in women. Br J Surg 2011;98:997–1002.
Humes DJ, Ludvigsson JF, Jarvholm B. Smoking and the Risk of Hospitalization for Symptomatic Diverticular Disease: A Population-Based Cohort Study from Sweden. Dis Colon Rectum 2016;59:110–4
Aune D, Sen A, Leitzmann MF, et al. Tobacco smoking and the risk of diverticular disease - a systematic review and meta-analysis of prospective studies. Colorectal Dis 2017;19:621–633.
Crowe FL, Appleby PN, Allen NE, et al. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ 2011;343:d4131
Strate LL, Liu YL, Syngal S, et al. Nut, corn, and popcorn consumption and the incidence of diverticular disease. JAMA 2008;300:907–14
Strate LL, Liu YL, Aldoori WH, et al. Physical activity decreases diverticular complications. Am J Gastroenterol 2009;104:1221–30.
Tonnesen H, Engholm G, Moller H. Association between alcoholism and diverticulitis. Br J Surg 1999;86:1067–8
Liu PH, Cao Y, Keeley BR, et al. Adherence to a Healthy Lifestyle is Associated With a Lower Risk of Diverticulitis among Men. Am J Gastroenterol 2017;112:1868–1876
Kvasnovsky CL, Papagrigoriadis S, Bjarnason I. Increased diverticular complications with nonsteriodal anti-inflammatory drugs and other medications: a systematic review and meta-analysis. Colorectal Dis 2014;16:O189–96
Claesson MJ, Jeffery IB, Conde S, et al. Gut microbiota composition correlates with diet and health in the elderly. Nature 2012;488:178–84.
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