BRAT Diet For Diverticulitis: Is It Really Effective In 2024?

Following a diverticulitis diet is often part of a suggested treatment plan, and some may suggest certain foods or other diets to help manage diverticulitis flare-ups, such as the BRAT diet. So is the BRAT diet for diverticulitis useful? While it can be helpful to manage outbreaks, it is not a diet that is recommended long term. 

In addition to managing painful flare-ups, other dietary interventions are recommended. This article will explore what to eat, what not to eat, and other things you can do to manage the condition.

Is The BRAT Diet For Diverticulitis Effective?

The BRAT diet, which stands for bananas, white rice, applesauce, and toast, is a bland elimination diet traditionally recommended for individuals recovering from digestive disorders such as diarrhea and vomiting. While it may temporarily relieve some digestive symptoms, it is not specifically designed to manage or prevent diverticulitis.

If you’re experiencing a diverticulitis flare-up, your healthcare provider may recommend a temporary low-fiber diet^[1] or a clear liquid diet to give your gastrointestinal tract time to heal. However, this should be done only for a short period. Once the symptoms subside, gradually reintroducing fiber-rich foods into your healthy diet is crucial for maintaining colon health and preventing future episodes of diverticulitis.

A diverticulitis diet may begin with only clear liquids progressing to a low-fiber diet of easily digested foods free of lactose. This reduces the urgency and frequency of stools. A low-fiber diet lessens gastrointestinal tract irritation allowing the tissues to heal. This diet aims to get less than eight grams of fiber per day while avoiding irritating foods, according to the Nutrition Care Manual of the Academy of Nutrition and Dietetics. 

On the other hand, a diverticulosis diet plan is typically high in fiber, emphasizing whole grains, legumes, fruits, and vegetables with limited refined grains.

Causes Of Diverticulitis

Diverticular disease is prevalent in industrialized countries^[2] and puts much pressure on the healthcare system. Diverticular disease happens when small pouches, called diverticula, form in the colon’s lining, poke through the colon’s muscle wall, and become inflamed or infected. 

Many factors influence the development of the disease, like age, diet, environment, lifestyle, gut bacteria, genetics, and how well the colon moves. However, it should be noted that not all those who have diverticula will develop diverticulitis. 

Several factors can contribute to the development of diverticulosis:

• Age: The risk of developing diverticulitis increases,^[3] particularly for people over 60.
• Low-fiber diet: A diet low in fiber^[4]-containing foods can lead to constipation and increased pressure in the colon, causing the formation of diverticula.
• Obesity: Being overweight or obese raises the risk of developing diverticulosis^[5] due to increased abdominal and colon pressure.
• Sedentary lifestyle: Lack of physical activity^[6] can contribute to the formation of diverticula and increase the chances of developing diverticulitis.
• Smoking: Smoking has been linked to an increased risk of developing diverticulosis^[7] as it can weaken the colon wall.
• Genetics: A family history of diverticular disease^[8] may predispose an individual to develop diverticulitis.
• Certain medications: Some medications,^[9] such as nonsteroidal anti-inflammatory drugs and steroids, have been associated with an increased risk of diverticulosis.

Difference Between Diverticulosis And Diverticulitis

Diverticulosis is simply the pockets that have formed in the bowel from a weakened intestinal lining. Diverticulitis occurs when those pockets become inflamed and infected. A diverticulosis diet plan is a high-fiber diet, but when infection occurs, one must follow a low-fiber diet that reduces inflammation in the digestive tract.

Foods To Include On The BRAT For Diverticulitis Diet

If you’re advised to follow the BRAT diet during a diverticulitis flare, here are some foods to include:

• Bananas: A good source of potassium, which helps replenish electrolytes lost during diarrhea.
• Rice: Plain white rice is low in fiber and easy to digest.
• Applesauce: Provides a source of natural sugars and pectin, which can help bind stool.
• Toast: Plain white bread or toast can be easily digested without butter or spreads.

In addition to these BRAT diet staples, you may also consider incorporating other bland, low-fiber foods such as:

• Crackers: Plain, unsalted saltine crackers can be easily digested.
• Clear broths: Chicken or vegetable broth can provide hydration and essential nutrients, which are great when prescribed a clear liquid diet.
• Boiled or baked potatoes: Skinless potatoes can be included as a bland, easily digestible food option.
• Plain pasta or noodles: Avoid adding sauces or seasonings, as they may exacerbate symptoms.

You may wonder, “Can I eat scrambled eggs with diverticulitis?” since it’s not on the BRAT list. However, scrambled eggs are soft and easy to digest; there is no reason to exclude them when you have symptoms related to infected pockets in the bowel unless the doctor asks you to stick strictly to the BRAT protocol.

Remember that the BRAT diet should only be followed for a few days during acute flare-ups and should not be considered your normal diet. You should gradually add foods, such as cooked cereals, to your diet after a flare-up. If you struggle to prepare meals appropriate for any health condition, consider a balanced meal delivery service.

Diverticulitis may also cause nutrient malabsorption, so it is worth supplementing with chewable multivitamins to cover any gaps in nutrition. Do not supplement with calcium during your flare-up, as this may cause an intestinal blockage.

Foods To Avoid With Diverticulitis

If you are prone to diverticulitis, avoiding foods that may exacerbate symptoms or cause further irritation to the colon is essential. These foods may differ from person to person, but here are seven of the most common:

• Red meat: Consuming large amounts of red meat^[10] has been linked to a higher risk of developing diverticulitis. Choose lean, well-cooked proteins like chicken, turkey, or fish as alternatives.
• Nuts and seeds: It was once believed that nuts and seeds could get lodged in diverticula and trigger inflammation, but recent research has questioned this^[11] in diverticulosis. However, in diverticulitis, since you are following a low-fiber diet, you should avoid nuts and seeds as they are high-fiber foods.
• Raw vegetables and fruits: Uncooked fruits and vegetables can be challenging to digest and are too high in fiber for a diverticulitis diet. Instead, opt for canned or cooked fruits and vegetables without seeds, skins, or hulls, which are easier on the digestive system.
• Spicy foods: Spices and hot sauces may irritate the digestive tract and worsen diverticulitis symptoms.
• Fatty or fried foods: High-fat and fried foods can be challenging to digest and may exacerbate symptoms. Avoid processed meats, fast food, low-fat foods, high-fat foods in general, and deep-fried items.
• Carbonated beverages: Soda and other carbonated drinks can cause gas and bloating, worsening discomfort during a diverticulitis flare.
• Alcohol and caffeine: Both alcohol and caffeine can irritate the digestive system, so avoiding them during a diverticulitis episode is best.
• Dairy products: If you have diverticulitis and diarrhea as a presenting symptom, avoiding lactose will be key to controlling your symptoms. Opt for lactose-free dairy options or take lactase, an enzyme that breaks down lactose. 

Other Ways To Keep Diverticulitis Under Control

In addition to making dietary adjustments, there are several other ways to help symptoms improve:

• Smoking has been linked to an increased risk of developing diverticulitis. Consider quitting or reducing your tobacco consumption to support colon health.
• Limit certain pain medications: Nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen may increase the risk of acute diverticulitis. Avoid using these medications frequently, and consult your healthcare provider for alternative pain relief options if possible.
• Maintain a healthy weight: Obesity has been linked to a higher risk of developing pockets in the bowel or diverticulosis. They can’t get infected if you don’t have pockets.
• High fiber diet: Some studies show^[12] that eating more dietary fiber or taking fiber supplements might help reduce your chances of developing diverticulosis and, thus, developing diverticulitis.
• Stool softeners: Stool softeners may be recommended to help prevent constipation, reduce strain on the colon, and other supplements for bloating. This is more common in uncomplicated diverticulosis.
• Probiotics: Probiotics help restore the balance of good bacteria in the gut and support overall digestive health. Various types of good bacteria^[13] have been shown to help with diverticulitis.

The Takeaway

Regular check-ups and communication with your healthcare provider can help you stay informed about your health conditions and receive personalized guidance on managing diverticulosis and preventing diverticulitis. It is not a one-size-fits-all condition, and what works for one person may not work for another. Therefore, a tailored plan and sometimes even surgical intervention may be essential for managing diverticulitis and maintaining overall health.

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