A systematic review of high-fibre dietary therapy in diverticular disease
Open Access
- 16 September 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal of Colorectal Disease
- Vol. 27 (4), 419-427
- https://doi.org/10.1007/s00384-011-1308-3
Abstract
Purpose The exact pathogenesis of diverticular disease of the sigmoid colon is not well established. However, the hypothesis that a low-fibre diet may result in diverticulosis and a high-fibre diet will prevent symptoms or complications of diverticular disease is widely accepted. The aim of this review is to assess whether a high-fibre diet can improve symptoms and/or prevent complications of diverticular disease of the sigmoid colon and/or prevent recurrent diverticulitis after a primary episode. Methods Clinical studies were eligible for inclusion if they assessed the treatment of diverticular disease or the prevention of recurrent diverticulitis with a high-fibre diet. The following exclusion criteria were used for study selection: studies without comparison of the patient group with a control group. Results No studies concerning prevention of recurrent diverticulitis with a high-fibre diet met our inclusion criteria. Three randomised controlled trials (RCT) and one case–control study were included in this systematic review. One RCT of moderate quality showed no difference in the primary endpoints. A second RCT of moderate quality and the case–control study found a significant difference in favour of a high-fibre diet in the treatment of symptomatic diverticular disease. The third RCT of moderate quality found a significant difference in favour of methylcellulose (fibre supplement). This study also showed a placebo effect. Conclusion High-quality evidence for a high-fibre diet in the treatment of diverticular disease is lacking, and most recommendations are based on inconsistent level 2 and mostly level 3 evidence. Nevertheless, high-fibre diet is still recommended in several guidelines.Keywords
This publication has 43 references indexed in Scilit:
- The Natural History of DiverticulitisJournal of Clinical Gastroenterology, 2004
- Mitochondrial DNA mutations in human colonic crypt stem cellsJCI Insight, 2003
- Persistent low prevalence of Western digestive diseases in Africa: confounding aetiological factorsGut, 2001
- DiverticulitisDiseases of the Colon & Rectum, 1996
- Assessing the quality of reports of randomized clinical trials: Is blinding necessary?Controlled Clinical Trials, 1996
- PREVALENCE OF DIVERTICULAR DISEASE, HIATUS HERNIA, AND PELVIC PHLEBOLITHS IN BLACK AND WHITE AMERICANSThe Lancet, 1985
- Diet and other factors in the aetiology of diverticulosis: an epidemiological study in Greece.Gut, 1985
- Does a high fibre diet prevent the complications of diverticular disease?British Journal of Surgery, 1980
- Bran tablets and diverticular disease.BMJ, 1976
- Unprocessed Bran in Treatment of Diverticular Disease of the ColonBMJ, 1972