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Diverticulosis vs. Diverticulitis: What’s the Difference and How to Manage Both

by Valerie Polley | Oct 29, 2025 | 0 comments

Many people are diagnosed with diverticulosis during a routine colonoscopy and are unsure what it means. While the terms sound similar, diverticulosis and diverticulitis are very different. While both conditions involve the colon, they differ in inflammation and symptom severity.

This blog post will clear up the confusion about the two conditions, explain management strategies, and address common myths about these common digestive conditions.

Diverticulosis vs. Diverticulitis—What's the Difference?

Before diving into myths and management strategies, it's important to understand the difference between diverticulosis and diverticulitis.

Diverticulosis

Diverticulosis is a term used to describe small pouches (called diverticula) that form in the lining of the colon. They're usually asymptomatic and are often discovered incidentally (such as during a routine colonoscopy).

The incidence of diverticulosis tends to increase with age and can affect over 70% of adults over 80. While it may present with mild symptoms like bloating, irregular bowel habits, and mild discomfort, in general, it doesn't cause too many issues.

Diverticulitis

Diverticulitis describes when one or more diverticula become inflamed or infected. Unlike diverticulosis, which tends to have mild or no symptoms, diverticulitis can manifest as abdominal pain (often on the lower left side), fever, nausea, and changes in bowel habits. 

Fewer than 5% of people who have diverticulosis will develop diverticulitis. Interestingly, the prevalence of diverticulitis by sex changes with age. While more men than women under 50 get diverticulitis, after age 50, diverticulitis is more prevalent in women.

Diverticulitis requires medical attention and sometimes antibiotics or hospitalization. Common complications of diverticulitis include:

  • Diverticular bleeding (when a small blood vessel in the diverticulum pouch bursts). This may be severe and life-threatening.
  • Abscess formation
  • Fistula formation (when an abnormal passage forms between the colon and another part of the body)
  • Blockage of the intestine
  • Colon perforation
  • Infection of the abdominal cavity lining (called peritonitis)

It's important to note that diverticulitis is a complication of diverticulosis, not a separate disease entirely.

What Causes Diverticula to Form?

There are many potential causes of diverticula formation, including:

  • A low fiber diet leading to constipation and higher colon pressure (from straining to have a bowel movement)
  • Aging and weakening of the intestinal walls
  • Smoking
  • Possibly changes in the gut microbiome and inflammation in the colon

In addition, genetics and lifestyle factors (such as inadequate physical activity or obesity) may also contribute. While we can't change age or genetics, diet and lifestyle can play a key role in preventing and managing diverticulosis.

Managing Diverticulosis

The goal of diverticulosis management is to prevent flare-ups and reduce the risk of diverticulitis occuring. Here are some tips I often share with my clients:

    • Eat a high fiber diet: Fruits, vegetables, whole grains, and legumes all provide fiber, which supports the microbiome and reduces the risk of constipation.
    • Stay hydrated to help fiber move through the intestines smoothly.
    • Exercise regularly to support a healthy body weight and bowel motility (the movement of waste through the bowels).
    • Avoid straining during bowel movements, as this can increase pressure in the colon and potentially lead to diverticula formation.

If you're currently following a low FODMAP diet (for IBS management) or other digestive health plan, it's important to increase your fiber intake slowly to avoid digestive symptoms like gas and bloating.

Managing Diverticulitis

Diverticulitis management depends on the severity of your symptoms. Mild cases can be managed at home with a combination of antibiotics, rest, and a temporary low-fiber or clear liquid diet to give your digestive system time to heal. More severe cases, especially those involving fever, significant pain, or complications like abscesses or bleeding, may require hospitalization, IV antibiotics, and, in rare cases, surgery to remove the damaged portion of the colon.

As your symptoms improve, it's important to gradually reintroduce fiber to support long-term gut health and reduce the risk of another flare. This typically happens in stages:

Clear liquids → low-fiber foods → high-fiber diet over time

During the clear liquid stage, stick with broths, clear juices, gelatin, and electrolyte drinks to stay hydrated and maintain energy. Once tolerated, transition to low-fiber foods such as white rice, plain pasta, white bread, canned peaches or pears, potatoes without skin, and lactose-free yogurt. Once you're feeling better, begin adding high fiber foods like oats, fruits, vegetables, beans, and whole grains—slowly, and with plenty of fluids.

Following up with your doctor and dietitian is key to preventing future episodes. They can help you develop a plan that balances fiber intake, supports regular digestion, and fits your personal tolerance.

Sample Diverticulitis Recovery Meal Plan

Everyone recovers at a different pace, so think of this as a gentle framework rather than a strict plan. Always follow your doctor or dietitian's guidance for your specific case.

Phase 1: Clear Liquids (1-2 days)

This phase gives your digestive system a rest while keeping you hydrated. Examples of foods to include are:

  • Clear broth or strained soups (chicken, vegetable, or bone broth)
  • Gelatin
  • Electrolyte drinks
  • Water, herbal tea, or diluted fruit juice (without pulp)
  • Popsicles made from pulp-free fruit juice

Dietitian Tip: Sip slowly throughout the day. The goal here is to keep you hydrated.

Phase 2: Low-Fiber, Soft Foods (2-4 days)

Once symptoms like pain and nausea subside, start to introduce easy-to-digest, low-fiber foods to help your body transition back to solids. Here are some foods to try:

  • White rice or plain pasta
  • Scrambled or poached eggs
  • Mashed potatoes (without the skin)
  • Canned peaches or pears in juice
  • Lactose-free yogurt or cottage cheese
  • White toast

Dietitian Tip: Stick to small, frequent meals every 3 to 4 hours to avoid overwhelming your gut.

Phase 3: Gradual Fiber Reintroduction (ongoing)

As you feel stronger, slowly reintroduce high-fiber foods to support long-term gut health and reduce the risk of recurrence. Try adding the following foods:

  • Oats, quinoa, or brown rice
  • Soft-cooked vegetables (carrots, zucchini)
  • Peeled apples or ripe bananas
  • Lentils or beans (in small portions at first)
  • Whole-grain bread and cereals

Dietitian Tip: Add one new fiber-rich food at a time and monitor your symptoms. Pair fiber with plenty of fluids, as water helps fiber move smoothly through your digestive system.

Common Myths About Diverticular Disease

 

Myth

Fact

You should avoid nuts, corn, and popcorn

Research shows no link between these foods and diverticulitis risk

Once you have diverticulosis, it always becomes diverticulitis

Only about 5% of people with diverticulosis develop inflammation

Fiber worsens diverticulitis

During a flare, a low-fiber diet is recommended, but long-term, fiber protects the colon

It's caused by spicy foods or stress

While stress can affect digestion (such as worsening constipation), diverticulitis is primarily linked to inflammation and pressure, not spicy foods

When to See a Doctor or Dietitian

If you experience persistent abdominal pain, fever, blood in your stool, or unintentional weight loss, it's important to see your doctor to rule out other causes of your symptoms, like inflammatory bowel disease (IBD) or colorectal cancer.

 If you're struggling with diet and lifestyle, a dietitian can help:

  • Gradually increase fiber safely
  • Build a personalized meal plan for symptom prevention
  • Support post-flare recovery and gut microbiome health

Remember, early intervention and professional guidance can reduce the recurrence of diverticulitis and improve overall quality of life.

Final Thoughts

Diverticulosis and diverticulitis are connected, but not the same. Diverticulosis refers to small pouches in the colon, while diverticulitis refers to the inflammation of these pouches. The key to preventing flare-ups lies in eating enough fiber, hydrating regularly, and getting adequate physical activity. With the right approach, you can live comfortably and confidently—without fear of flare-ups or outdated myths holding you back.

If you're struggling with making lifestyle changes to support a healthy gut, consider reaching out to us at Blue Tree Nutrition to schedule an introductory call. 

"Processed food" has become a catch-all term for foods we're told to avoid, but food processing isn't automatically a bad thing.

Technically, many foods you probably enjoy regularly are processed. Frozen vegetables, canned beans, yogurt, nut butter, and whole-grain bread have all been changed from their original state in some way.

So when research links processed foods to certain health concerns, it's important to understand what kind of processing we're talking about.

Much of the recent research has focused specifically on ultra-processed foods (UPFs). Diets containing large amounts of these foods have been linked to a range of negative health outcomes, including digestive and metabolic health issues, inflammation, and heart disease.

This article will review what we know so far and give you tips for including more whole foods in your diet.

Processed vs. Ultra-Processed Foods: Understanding the Difference

In food and nutrition research, a system called the NOVA classification is often used to group foods according to the type and extent of processing they undergo.

Minimally processed foods include fruits, vegetables, eggs, milk, and plain grains that may have been washed, frozen, pasteurized, dried, or otherwise prepared without significantly changing them from their original state.

Processed foods are generally made by adding ingredients such as salt, sugar, or oil. Examples include canned vegetables, cheeses, or freshly made breads.

Finally, ultra-processed foods are industrial formulations containing ingredients or additives not typically used in home cooking. Examples include many sodas, packaged snacks, instant noodles, candies, and some ready-to-eat meals.

This distinction is important because simply avoiding all processed foods would mean missing out on many convenient and nutritious options (such as canned beans and vegetables).

It's also important to recognize that there's considerable variation among foods categorized as UPFs. For example, a packaged whole-grain bread and a soda may both meet the criteria for ultra-processing under the NOVA classification, despite having very different nutritional profiles. 

Instead of deciding not to eat a food simply because it's processed, it can be more useful to look at the bigger picture and consider what nutrients the food provides and how it fits into your overall diet.

How Can Ultra-Processed Foods Affect Digestion?

While we're still uncovering exactly how UPFs affect the digestive system, one possibility is that they lack fiber.

Some diets high in UPFs are lower in naturally fiber-rich foods like fruits, vegetables, whole grains, beans, lentils, nuts, and seeds. You probably know fiber is important for staying regular, but certain types of fiber (known as prebiotics) act as food for the beneficial bacteria living in your gut. A diet lower in fiber may therefore affect both digestion and the health of your gut microbiome. 

There's also research currently examining the effects of common additives found in UPFs, such as certain emulsifiers and artificial sweeteners. However, most of the research linking these additives to negative effects on the gut microbiome and intestinal barrier has been conducted in vitro (test tube) or animal studies, so more research is needed before we can confirm whether these additives are harmful in humans.

Finally, some studies have found links between UPF intake and certain gut conditions. For example, a large systematic review and meta-analysis found that higher UPF consumption was associated with an increased risk of developing Crohn's disease.

However, there's still a lot we don't know about how UPFs impact gut health, and more research in humans is needed to understand which food components or other dietary factors may be responsible.

UPFs and Inflammation

Chronic, low-grade inflammation has been linked to the development of several chronic diseases, prompting researchers to investigate whether diets high in UPFs could contribute to inflammation.

Here are a few possible explanations:

  • A diet high in UPFs may contain fewer foods rich in fiber, vitamins, minerals, and phytochemicals, which are associated with better overall diet quality.
  • A diet high in UPFs can also contribute significant amounts of refined carbohydrates, saturated and trans fats, sodium, or added sugars.
  • Certain ingredients in UPFs may alter the gut microbiome and promote gut inflammation.

However, much of the evidence connecting UPF intake with inflammation and chronic disease is observational. Studies like these can identify patterns, but they can't always tell us whether UPFs specifically are responsible or whether other differences in diet and lifestyle contribute to the association.

UPFs and Overall Health

The research on UPFs becomes more conclusive when we zoom out to consider overall health.

A 2024 umbrella review published in The BMJ found that higher exposure to UPFs was linked with increased risk across several health outcomes, with some of the strongest evidence involving heart disease, type 2 diabetes, mental health outcomes, and overall death rates.

However, it's important to note that the quality of the studies included in the review varied considerably. Only four of the 45 studies they reviewed received a moderate-quality rating; most were rated low or very low quality.

That said, there is some experimental evidence to consider. A small but well-controlled study of 20 adults found that those eating UPFs consumed an average of 500 additional calories per day and gained about 2 pounds. They lost a similar amount of weight when eating the minimally processed diet. The study showed that something about the UPF dietary pattern encouraged greater calorie intake, but it couldn't identify exactly which UPF component was responsible.

Do You Need to Stop Eating UPFs?

UPFs can provide valuable nutrients, and all foods classified as UPFs are not nutritionally identical. Instead of trying to eliminate all foods that qualify as UPFs, consider your overall dietary pattern. For example:

  • Are you including fruits and vegetables throughout the day (fresh, frozen, or canned)
  • Are you choosing whole grains and other fiber-rich foods regularly?
  • Do you include beans, lentils, nuts, and seeds in your diet?
  • Do you compare packaged foods based on what nutrients they actually provide rather than assuming that processing alone determines their nutritional value?
  • Do you use convenience foods like canned beans and vegetables to make balanced meals easier, rather than feeling overwhelmed trying to prepare everything from scratch?

If UPFs currently make up a large portion of your diet, you don't need to overhaul everything overnight. Instead, try adding more minimally processed, nutrient-dense foods alongside the foods you already enjoy.

The Bottom Line

Food processing exists on a spectrum, and processed doesn't automatically mean unhealthy.

Research suggests that diets high in UPFs are associated with several health concerns, but researchers are still working to determine why these associations exist and whether all foods classified as UPFs carry the same risks.

Rather than fearing individual foods, focus on your overall dietary pattern. A diet built around a variety of fiber-rich plant foods, adequate protein, and nutrient-dense choices can still leave room for the occasional UPFs.

If you need help incorporating more whole foods into your diet, a dietitian can help. Click here to book an appointment with us at Blue Tree Nutrition.

 

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Hello, I am

Valerie

My name is Valerie Polley. I am a Indianapolis-based registered dietitian and owner of Blue Tree Nutrition. I consult with clients both local and far away.
I have a bachelor’s degree in nutrition from Purdue University and I have been practicing for 20 years.
I thoroughly enjoy helping clients through their gut health journey. I see a range of GI issues including, but not limited to celiac disease, IBS and SIBO. I also specialize in the FODMAP elimination diet.

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