Nutrition for Diverticulitis & Chronic Pain: Bill’s Story

When Bill, an avid foodie and home cook, began to suffer from chronic abdominal pain, he sought help with nutrition for diverticulitis. After years of living with chronic pain and discomfort, his doctor recommended surgery—as well as a full nutritional overhaul. To learn more about how he could manage his symptoms, while maintaining his enjoyment of food and cooking, Bill sought support from Culina Health Registered Dietitian, Nahyeli Perpiñá, MS, RDN, CNSC.

In this interview, Bill reflects on his health journey, the process of reintroducing certain foods after illness, and more of what he’s learned working with a registered dietitian. 

A Wake-Up Call

What led you to initially seek help from a dietitian?

For years I had struggled with chronic diverticulitis, and with it, chronic pain that would seem to occur with no direct connection to one particular food or food group. Before getting my diagnosis, I had tried a low-FODMAP diet, a gluten free diet, and a dairy free diet, but soon it became clear that I needed to have surgery. It also became clear to me that the path forward after surgery was going to happen one meal at a time and to do that well, I was going to need to work with a dietitian to navigate to a new and equally delicious normal. 

How would you describe your physical and mental state before beginning your work with an RD?

Before my sessions started, I felt hopeless and blind to the ability to navigate good, nutritious, and satisfying food choices for myself. I suddenly saw an entire world around me that on the surface seemed to prioritize and make readily available all of the things I needed to avoid leading up to surgery. As a foodie, I felt like my world had been turned upside down. 

The Road to Recovery

What were some of the biggest challenges you faced before and after your sigmoidectomy?

The biggest challenge for me was identifying and navigating a food landscape that was not going to make my condition worse. The initial focus with my Culina Health dietitian, Nahyeli, was all about foods that were low in fiber and anti-inflammatory until after my surgery. Another challenge was managing the mental connection between certain foods and how I was feeling. Finally, there was the general fear of having a surgery of this magnitude, and what my life would be like during and after recovery. I honestly felt like a broken person. 

What specific strategies or advice did you find most helpful in easing your symptoms and supporting your recovery?

During the pre- and post-op phases of my journey, it was very helpful for Nahyeli to define what foods and food groups were “in” and what was “out” given where I was at the time. Because I love to cook, I tried to be as creative as possible to try and minimize the feeling that I was missing out on life. For example, prior to my surgery I started to make delicious and low fiber soups and smoothies made with anti-inflammatory ingredients Nahyeli taught me about like turmeric, garlic, and ginger. 

After surgery, Nahyeli taught me about the fiber-rich nature of legumes and I began to re-introduce them into my diet through a variety of dishes. I have found that I really love legumes! Nahyeli also taught me how to methodically re-introduce a food into my diet after surgery. We used a three day window for each new food item like farro, spinach, onions, and garlic; introducing one at a time and then evaluating how I felt before I would move onto something new. This may seem impossible, but it isn’t. Easing into my new normal was an adventure and I was rewarded with every bite that made me feel better every single day.

How did you initially feel about the idea of reintroducing fiber into your diet?

Honestly, I was frightened. After surgery, my body was sending a lot of signals, and the mental connection between abdominal sensations and my condition remained strong. That said, my surgeon assured me that all of the problematic tissue was removed and that the sensations and mild discomfort I was feeling were the journey of recovery and that helped  to approach the re-introduction of fiber into my diet and also an expansion into a higher fiber regime with patience and an open mind. 

Working with a Culina Health Registered Dietitian

Can you share your experience with the education and resources provided to you throughout your journey?

My personalized care plan was invaluable. I also found the low-fiber and the anti-inflammatory handouts to be exceedingly helpful resources. Nahyeli also gave me a handout of how to properly make a smoothie and I learned I was doing it all wrong!

How has your overall health and well-being improved since following your personalized dietary plan?

Since I started to work with Culina and Nahyeli in particular, I am probably in the best health of my life. My weight is in the normal range for my height, my blood pressure is completely normal, my cholesterol is great – I could not have hoped for a better outcome given where I started this journey nearly 8 months ago. I also have more energy, am less hungry, and I sleep so much better at night. My weight also seems to be holding in a consistent place. 

What specific changes or improvements have you noticed in your GI symptoms after working with your dietitian?

Hopefully not TMI, but I have completely normal and regular bowel movements now. I have never had that happen in my life. Prior to my procedure I would move between constipation and diarrhea and I found myself running to the bathroom multiple times throughout the day. Based on how I feel today I have come to recognize this as a combination of my condition and an imbalance in my gut microbiome. As I have moved into a higher-fiber eating pattern and have increased the diversity of nutritious and fresh ingredients into my diet, my GI tract has quieted down considerably to what I would say is a balanced state. 

How would you describe your overall experience working with your dietitian?

Simply amazing. Nahyeli is professional, patient, kind, and understanding. I could not have done this without Nahyeli. She is very skillful and methodical in her approach and is such a good listener and adviser.

Reflecting on the Journey, Looking Towards the Future

How has your understanding of your condition and dietary needs changed since beginning this process?

I am a whole new me as a result of this process. I am more mindful of the dietary choices I am making, the amount of calories I am consuming, and what I really need in my diet to feel satisfied. Prior to my dietary and medical journey, I would free-range eat, not necessarily aware of what I was actually putting in my body and how that was affecting my medical condition. I now understand what balance and satisfaction look like. I can have a cup of coffee and eat a piece of chocolate and enjoy it without fear. These days I tend to avoid all foods with inflammatory ingredients and also most processed foods. I love to cook, so this time has been a wonderful re-commitment to my kitchen and my cooking. 

What have you learned about managing your diet and health that you didn’t know before?

I have learned three things. The first is that I am not hopeless in this journey and the only one holding me accountable to make good choices is me.The second is that it’s important to be mindful of what is in the food I am buying. For my condition, some brands sneak ingredients into their products that are easy to avoid if you just do a little digging into alternate brands or just making it myself. Finally, I’ve embraced creativity in my cooking. There are so many wonderful recipes online and amazing adaptations that can be made with almost no effort that can make a world of difference in meeting an individual’s dietary goals and objectives. For example, adding a quarter teaspoon of turmeric to a smoothie, adding black beans to an omlet, making risotto with farro as opposed to rice (trust me it is amazing), or even choosing whole wheat bread over white are small little adjustments that the old me would have never thought about. 

How confident do you feel about managing your diet and GI health moving forward?

I’ve never been more confident about anything in my life. Choosing to work with a dietitian was one of the best decisions I’ve ever made. I know I’ve made choices that have put me on a path to lifelong nutrition and balance.

Finally, what would you say to someone considering nutritional help for similar GI issues?

Firstly, you don’t have to do this alone. It is daunting and scary, but with a little patience and mindfulness, you can find a path with your dietitian that works for you. Second, give yourself space and grace. Working through a GI condition is tough, particularly if it leads you to surgery. It feels like your body is betraying you and you realize your mind and your gut are in a constant tug of war. The goal is to get back to balance and that sometimes requires a professional helping hand. Finally, things will not change overnight. It’s important to find a way to track your progress in a meaningful way. For me it was tracking grams of fiber in my food and my water intake as I recovered through a food app and watching that increase over time until I hit my goal. 

Interested in working with a registered dietitian to meet your health goals?

At Culina Health, we believe that everyone deserves affordable, quality nutrition care from a credentialed nutrition expert. We pair patients with registered dietitian nutritionists for personalized, virtual nutrition care that is science-based, inclusive, and culturally affirming. We offer non-judgmental, sustainable, and multilingual support in all specialties, and we honor all patient backgrounds. Culina Health is proud to be clinician-, women-, and BIPOC-owned. Start today.