Diverticulitis/ Diverticulosis/ diverticular disease Medical nutrition therapy

Diverticulitis vs Diverticulosis

Diverticulitis vs Diverticulosis.

Confused by diverticulitis vs diverticulosis? Learn the key differences in symptoms and how expert dietary changes can help prevent painful flare-ups.

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What is the difference between Diverticulitis & Diverticulosis?

Diverticulitis illustration Piccin, A. et al. (2023)

1. Diverticulosis 

is a very common condition where small pouches or pockets form in the wall of your large intestine/ bowel.

  • This is the physical structural difference from a disease free bowel.
  • It is usually asymptomatic (does not cause any symptoms and you can’t tell it is there unless tested for)

2. Diverticular Disease

is when Diverticulosis causes symptoms such as

  • Mild cramps or lower stomach pain that may come and fo
  • Bloating
  • Inconsistent or irregular bowels

3. Diverticulitis

is when the small pouches of diverticulosis “flares up”, becomes irritated and/or is infected. This may commonly lead to one or multiple of the following:

  • Significant sharp & intense pain and/ or cramping in lower stomach/ abdomen
  • Fever
  • Nausea &/ or vomiting
  • Loss of appetite
  • Constipation or diarrhoea
  • Blood in stool

What causes diverticulosis and diverticulitis?

Diverticulitis is a multifactorial disease, meaning that multiple things appear to contribute to its development.

Its primary influence is low fibre intake (meaning low vegetable, nut, fruit and legume intake) and dehydration in the diet over many years. Additional contributors can be

  • Reduced physical activity & exercise
  • Pushing when going to the toilet and chronic/long-term
    constipation.
  • Obesity
  • Smoking
  • General “wear and tear” of our bowels as we age
A person with sharp pain/ stomach pain from bloating, dull stomach ache/ cramping/ sharp pain/

What we can do

How is Diverticulitis treated?

Once diagnosis has been confirmed via your Doctor, treatment may depend on the severity/ stage of the disease or if there are complications present.

  • Diverticulosis: For a large portion of cases, dietary intervention of higher fibre intake should be sufficient in preventing progression or flare ups to Diverticulitis.
  • Diverticulitis (flare up): For more severe &/ or frequent cases,
    • A bowel rest diet may be begun including 2-3 days of clear fluids (no solids and no fluids that are not transparent), followed by a easy to chew & soft foods diet until pain improves. Once pain improves, resuming a higher fibre diet is recommended. If you’re looking for further support, a Dietitian is a nutrition expert and can assist with meeting your requirements
    • Your Doctor may recommend medicines or surgery (colectomy) to support your quality of life if severe enough

How common is Diverticulitis? (Diverticulitis statistics)

Diverticular disease is a very common disease in Australia and globally.

  • 1 In 3 Australians over the age of 45 have diverticular disease
  • 1 in 2 people over 80 have the disease.
  • A large portion of cases are asymptomatic and unnoticeable in daily life

Victoria & Melbourne Specifics

  • Melbourne Hospital Admissions: Acute diverticulitis is a leading cause of acute surgical admissions across Melbourne’s major health networks (such as Austin Health and Monash Health).

  • Treatment Costs: Private treatment costs in Melbourne for complicated diverticulitis (including potential surgical intervention) can be more than $35,000, reflecting the complexity of managing severe cases and long-term follow-up.

  • Tertiary Hospital Burden: Melbourne hospitals have increasingly adopted “outpatient management” protocols for uncomplicated cases to manage the high volume of presentations, as roughly 90% of cases in Western populations like Melbourne occur in the left (sigmoid) colon.

Image of a girl with stomach pain, bent over in stomach pain from bloating/ cramping/ sharp pain/ dull stomach ache

When should you see a Doctor for Diverticulitis?

See your doctor if you have:

  • Cramps or lower abdominal (tummy) pain
  • Irregular bowel habits, alternating episodes of constipation and diarrhoea
  • Blood in your stool (poo)

When should you see a Dietitian for Diverticulitis/Diverticulosis?

For personal assistance with modifying your diet because of diverticular disease,

management experts are Accredited Practising Dietitians (APD).

We recommend seeing a dietitian if you:

  • Have been diagnosed with diverticular disease and want some
    support on dietary management of this condition
  • Would like to optimise healing rate of diverticula
  • Are struggling with any of the symptoms of diverticular disease
  • Need nutritional advice to help ensure you’re meeting your individual nutrient requirements
  • Would like advice on ways to have more high-fibre foods in your diet
  • Would like personalised advice and support from a professional.

Accredited Practising Dietitians (APDs) are university-trained nutrition experts.

They can help you with personalised, easy-to-follow and evidence-based advice.

Why Choose REAL for Supporting Your Diverticulitis?

At REAL Health & Nutrition, we believe that restoring your weight and rebuilding your strength shouldn’t come at the cost of enjoying your meals.

Our Melbourne-based Accredited Practising Dietitians (APD) use compassionate, evidence-based Medical Nutrition Therapy to help you regain your energy, preserve your vital muscle mass, and feel resilient and in control of your body again.

Realistic nutrition solutions

REAL Health & Nutrition was founded in Melbourne by Matthew Rigoni alongside a passionate team that provides evidence-based nutrition strategies that fit into your life.

Our diverse clientele includes individuals seeking to manage chronic disease, enhance their energy, and those aiming to improve their healthspan and longevity through sustainable health and nutrition strategies.

Matthew Rigoni, expert Dietitian and sports dietitian- REAL Health & Nutrition

Practitioners

Meet the team

Highly skilled and qualified Dietitians and Sport Nutritionists

  • Matthew Rigoni Accredited Practising Dietitian (APD), sport Nutritionist, Accredited Sport Dietitian (ASD)

    Matthew Rigoni

    Head Dietitian (APD) & Sports Nutritionist

    Matthew Rigoni is an Accredited Practising Dietitian and Sports Nutritionist supporting clients across Eltham, Diamond Creek and Melbourne’s North-East. He specialises in weight management, chronic disease care, IBS/low-FODMAP nutrition, and sports-performance nutrition. His approach focuses on evidence-based, realistic strategies tailored to each client’s health goals. Matthew also brings experience in strength training and rehabilitation, helping clients build long-term, sustainable habits.

  • Max Dennehy Dietitian, body building coach

    Max Dennehy

    Dietitian and Bodybuilding Coach

    Max Dennehy is a qualified Dietitian with strong expertise in sports nutrition, weight loss, muscle gain and body recomposition. He has more than seven years of hands-on experience in bodybuilding and strength training, blending clinical nutrition with practical performance coaching. Max supports clients managing chronic conditions, improving metabolic health, and achieving body-composition goals. His coaching style is structured and supportive, helping clients stay consistent and confident.

  • Emma Westlake Accredited Sports Nutritionist

    Emma Westlake

    Accredited Sports Nutritionist

    Emma Westlake is a Nutritionist and Accredited Sports Nutritionist with experience in athletic performance, endurance nutrition, injury recovery and rehabilitation. She brings a strong background in Biomedical Science and works with clients to improve energy, health and long-term wellbeing. Emma has supported athletes across AFL/AFLW, triathlon and running communities, offering clear and practical guidance. Her passion lies in helping active individuals optimise performance through personalised, evidence-based nutrition.

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This commitment ensures you always receive the most current, evidence-based nutrition guidance available.

Frequently Asked Diverticulitis Questions

Questions for Diverticulosis, Diverticular Disease & Diverticulitis 

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    Yes! It was prior thought that small and hard food items such as seeds, corn, nuts and popcorn would get stuck in the small pockets/ pouches in diverticular disease.

    There is currently no evidence supporting these claims and, in fact, it appears that consuming these foods may actually reduce the risk of diverticulitis/ fare ups

    Unfortunately, no.

    There is currently no evidence that supports the use of probiotics to prevent flare ups.

    Currently, there is very poor evidence for either low fibre or high fibre diets while a flare up is active.

    Usually, this decision should be made on a case by case basis and taking into account the complexity of your condition/ situation

    It won’t provide the best outcomes with your health.

    While the current evidence for supporting dietary fibre intake is not completely conclusive, we at REAL conclude that the wide micronutrient intake that accompany high fibre foods may assist with the healing process (and reduce occurrence of aditional chronic disease).

    In combination with the fibre int the food, which you do not achieve with the supplemental form alone, the current scientific concensus deems that a whole food approach to be best, with potential for supplementation where there are nutrition gaps

    If your goal is to reduce the risk of a flare up/ diverticulitis as
    much as possible, then yes.

    There is strong evidence to support that physical activity decreases the occurrence of diverticulitis. 

    While there is no specific link, chronic muscle tightness and contractions, colonic pressure and systemic inflammation all theoretically have rolls in the development of diverticulosis.

    That additional pressure may translate through the gut-brain axis and lead to worsening symptoms or reducing our tolerance to certain foods

Extra reading

References:
Dahl, C., Crichton, M., Jenkins, J., Nucera, R., Mahoney, S., Marx, W., & Marshall, S. (2018). Evidence for Dietary Fibre Modification in the Recovery and Prevention of Reoccurrence of Acute, Uncomplicated Diverticulitis: A Systematic Literature Review. Nutrients, 10(2), 137. https://doi.org/10.3390/nu10020137 

Dietitians Australia. Diverticular disease, Dietitians Australia. Available at: https://dietitiansaustralia.org.au/health-advice/diverticular-disease (Accessed: 20 January 2025). 

Health Direct Diverticular disease – diverticulitis and diverticulosis, healthdirect. Available at: https://www.healthdirect.gov.au/diverticular-disease-and-diverticulitis (Accessed: 20 January 2025). 

MacKee, N. Uncomplicated diverticulitis: Putting antibiotics on hold, InSight+. Available at: https://insightplus.mja.com.au/2019/29/uncomplicated-diverticulitis-putting-antibiotics-on-hold/ (Accessed: 20 January 2025). 

NIDDK Diverticular Disease – NIDDK, National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis (Accessed: 20 January 2025). 

Piccin, A. et al. (2023) Diverticular disease and Rifaximin: An evidence-based review, MDPI. Available at: https://www.mdpi.com/2079-6382/12/3/443 (Accessed: 20 January 2025). 

Strate, L.L. et al. (2009) ‘Physical activity decreases diverticular complications’, The American Journal of Gastroenterology, 104(5), pp. 1221–1230. doi:10.1038/ajg.2009.121 

Weisberger, L., & Jamieson, B. (2009). Clinical inquiries: How can you help prevent a recurrence of diverticulitis?. The Journal of family practice, 58(7), 381–382. https://pubmed.ncbi.nlm.nih.gov/19607778/