Diverticular disease is a condition which affects the large intestine. Diverticulosis occurs when small pouches (diverticula) develop in the lining of the large intestine. Diverticulitis is when these pouches become inflamed or infected.
Diverticular disease is most common in people aged over 50 years, with older age and diet being considered the main risk factors. It is thought that a low fibre diet may increase an individual’s chance of developing diverticular disease. Genetics is also thought to play a role in diverticular disease.
A person with diverticulosis may experience abdominal pain and bloating, constipation or diarrhoea and flatulence; however the majority of people with diverticulosis with have no symptoms. Symptoms of diverticulitis on the other hand tend to be more serious and can include severe abdominal pain, fever, nausea, vomiting, diarrhoea and bloating. A person with an episode of diverticulitis will generally always require medical attentional to ensure further complications to not develop.
Managing a residents diet can be an effective way to help manage their diverticular disease. For a resident with diverticulosis, gradually introducing a high fibre diet will usually lead to an improvement in bowel habits and less pressure on the bowel. Foods to encourage would include fruits and vegetables, wholemeal breads, high fibre cereals, oats and psyllium. It is recommended that residents include high fibre foods with each of their meals and snacks. Ideas could include:
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Some people with diverticular disease prefer to avoid nuts, seeds and pips, due to the concern that they may become caught in the diverticula resulting in an infection. While there is no specific evidence to support this, many people prefer to be cautious and eliminate these foods from their diet. Adequate fluid is also vital to ensuring good bowel health. Encouraging residents to maintain their hydration is also key.
When a person is having a diverticulitis episode, it is important to follow a low fibre diet until their symptoms improve. This is to give the bowel some ‘rest’ and to assist in minimising irritation while the bowel is inflamed. A low fibre diet would consist of foods such as white breads/pasta/rice, a small amount of peeled and well cooked vegetables, a small amount of peeled fruit, dairy foods (yoghurt/milk/custard/cheese), all meals/chicken/fish/eggs. Ideally fruit should be limited to 1 piece/day and vegetables to about ½ cup/day when following a low fibre diet.
In summary, it is beneficial to assess the diets of all residents with diverticular disease to ensure they are receiving adequate fibre in their diet with the hope of limiting diverticulitis episodes.