From the Guidelines
Mild diverticulosis typically requires no specific treatment if it's asymptomatic, with the primary approach focusing on dietary modifications to prevent constipation and reduce pressure in the colon. The main goal is to prevent complications like diverticulitis by maintaining a healthy bowel habit. Key recommendations include:
- Increasing fiber intake to 25-35 grams daily through fruits, vegetables, whole grains, and legumes 1
- Staying well-hydrated by drinking at least 8 glasses of water daily
- Regular physical activity to promote healthy bowel movements
- Considering fiber supplements like psyllium (Metamucil), methylcellulose (Citrucel), or polycarbophil (FiberCon) for those who cannot get enough fiber through diet alone
- Avoiding unnecessary restrictions on seeds and nuts, as research hasn't shown they increase complications 1 If mild symptoms occur, over-the-counter pain relievers like acetaminophen may help, but NSAIDs should be used cautiously as they can irritate the digestive tract. Antibiotic treatment is not routinely recommended for mild uncomplicated diverticulitis in immunocompetent patients, but may be considered in patients with comorbidities, refractory symptoms, or elevated inflammatory markers 1. Overall, the focus should be on preventive measures and lifestyle modifications to reduce the risk of complications and promote overall gastrointestinal health.
From the Research
Treatment for Mild Diverticulosis
- The treatment for mild diverticulosis focuses on managing symptoms and may involve dietary changes 2.
- During symptomatic periods, patients may be advised to follow a low-fiber, bland diet, but once the acute episode resolves, they should gradually increase their dietary fiber to 20 to 30 grams daily 2.
- A high-fiber diet may help prevent recurrence of diverticulitis, although direct evidence is limited 3.
- There is no evidence to support avoiding nuts and seeds to prevent diverticulitis, and in fact, nuts and popcorn may have a protective effect 3.
- Dietary fiber supplementation has been advocated to prevent diverticula formation and recurrence of symptomatic diverticulosis, based on observational studies 4.
Dietary Recommendations
- A fiber-rich diet (25-40 g/day) plays an important role in prevention and nonpharmacological treatment of uncomplicated diverticular disease 5.
- Drinking adequate water and excluding products that decrease colonic transit time may also be beneficial 5.
- Probiotics may be effective in dietary management during the remission process 5.
- However, a high-fiber diet does not necessarily protect against asymptomatic diverticulosis, and may even be associated with a greater prevalence of diverticulosis 6.