What should I eat?

Keeping the stools relatively soft and bulky may reduce the likelihood of more diverticula developing and may reduce the risk that hard pellets of faeces lodge within the pouches. In principle a diet high in plant fibre achieves both aims. Try to eat a mixture of high fibre foods. Fruit, vegetables, nuts, wholemeal bread and pasta, wholegrain cereals and brown rice are all good sources of fibre. Aim to have at least one high fibre food with each meal and try to have five portions of fruit or vegetables each day. Drink at least two litres (8 to 10 cups) of fluid every day.

People with symptoms from diverticular disease respond differently to fibre in the diet. One person may be helped by increasing the amount of plant fibre in the diet, another may feel that their symptoms become worse. The type of fibre one eats may usefully be varied. Some people find that it helps to take fibre in the form of fruit and vegetables (soluble fibre) rather than that in cereals and grains (insoluble). This is because insoluble fibre may cause more bloating and pain. Bran aggravates symptoms for some people and is not routinely recommended. Avoiding large or fatty portions of food is a common sense measure if symptoms are worse after meals. It is not possible to make rules about diet which suit everyone - an element of trial and error in what we eat is often helpful in finding what fibre suits us best.

Do symptomless diverticula need treatment?

No treatment is necessary for diverticula that are discovered incidentally. However, it may be wise to suggest a high-fibre diet to try and prevent symptoms from developing later. It is not certain whether taking more fibre will necessarily prevent such symptoms.

Medical treatment of symptoms

There is no specific treatment for persistent pain, bloating or an irregular bowel habit. The dietary measures described above may be helpful. It is possible to take medicines which contain fibre such as ispaghula husk or
methyl cellulose preparations which soften the stools. Your pharmacist will be able to advise. Some doctors may prescribe an antispasmodic drug but the results are often disappointing. An antibiotic may be tried if inflammation is suspected but pain-killers such as codeine should be avoided as they tend to cause constipation.