I hesitate to recommend another research article to read, BUT this narrative review from September 2025 was too enjoyable not to share.
Fibers and Polyphenols in Diverticular Disease: From Pathophysiology to Management
Maybe I loved it because it confirmed so much of what I’ve seen firsthand while working with people with diverticulosis and diverticulitis.
While I usually focus on IBD (mostly Crohn’s disease and ulcerative colitis), many people with IBD also have diverticular disease—and most of us see general GI cases too (or at least know someone with diverticulosis).
Pro tip for RDNs: I’ve had quite a few people reach out over the years simply because I list diverticulosis/diverticulitis among the conditions I see. If you’re comfortable managing it and want to increase patient referrals, add it to your list.
So while I encourage you to read the full article when you have 15 minutes (especially if you’d appreciate a refresher on diverticulosis, symptomatic uncomplicated diverticular disease and diverticulitis), here are a few practical takeaways to keep in mind:
💩 Prevent Constipation Before It Becomes a Problem Hard, dry stool can obstruct diverticula, triggering the progression from diverticulosis to diverticulitis.
Almost every person I’ve seen with diverticulitis recalls constipation leading up to their flare—straining, pebble-like stools, incomplete evacuation, or going days without a BM.
👉 Encourage hydration, fiber-rich foods as tolerated, and consistent bowel routines to prevent constipation in at-risk individuals.
🧪 Use Labs to Personalize Care Fecal calprotectin may help differentiate symptomatic diverticular disease from IBS, where symptoms often overlap.
Higher CRP levels after acute diverticulitis predict a higher recurrence risk.
👉 Use these biomarkers to guide follow-up plans and tailor nutrition interventions.
💊 Consider Rifaximin When Appropriate The unabsorbable antibiotic Rifaximin—often used for SIBO—may help reduce inflammation and symptoms in uncomplicated diverticular disease.
👉 Work with the medical team to see if it could help those with symptomatic uncomplicated diverticular disease.
🥦 Encourage a Fiber-Rich Diet Adequate fiber helps normalize GI transit, improve BMs, reduce intraluminal pressure, and support beneficial gut microbes—all of which may help prevent diverticulosis, diverticulitis, and related symptoms.
👉 Personalize fiber recommendations to promote tolerance and long-term success.
🍇 Promote Polyphenol Variety Polyphenols may reduce inflammation and oxidative stress while supporting intestinal barrier integrity, helping protect against diverticulitis.
👉 Encourage eating the rainbow. Table 1 in the article lists fruits rich in polyphenols associated with reduced diverticulitis risk.
🦠 Probiotics: Might Help, Probably Won’t Hurt Evidence remains mixed due to varying strains and dosages, but for some, probiotics may be worth a try.
👉 If someone’s interested, consider a short trial of a probiotic containing Lactobacilli or Bifidobacteria and monitor symptoms. Unfortunately, we still don’t have strain-specific guidance.
📉 Keep It Simple and Sustainable Because diverticulosis is asymptomatic for most, research is limited—but we know there is a role for nutrition in both symptom management and disease progression.
👉 Emphasize fiber- and polyphenol-rich, minimally processed diets personalized to each person’s tolerance and lifestyle.
For Non-RDN Readers Living with Diverticular Disease
Stay hydrated, aim for regular BMs, gradually add more plants and fiber-rich foods that feel good, and connect with a GI dietitian if you need guidance.
