From the Guidelines
Patients with diverticulitis who have undergone partial colectomy can generally use psyllium fiber supplements, but should do so cautiously and under medical supervision. The American Gastroenterological Association suggests a fiber-rich diet or fiber supplementation in patients with a history of acute diverticulitis, although the quality of evidence is very low 1. When using psyllium fiber supplements, it is essential to start with a low dose, typically 1 teaspoon (about 3.5 grams) mixed with 8 ounces of water once daily, and gradually increase to 1-2 tablespoons (7-14 grams) daily divided into multiple doses as tolerated. Some key considerations when using psyllium fiber supplements include:
- Always taking psyllium with plenty of water to prevent constipation or blockage
- Waiting until the surgeon confirms complete healing (usually 4-6 weeks post-surgery) before starting fiber supplements
- Temporarily discontinuing fiber supplements during acute diverticulitis flares until inflammation resolves
- Discontinuing use and consulting a healthcare provider if increased abdominal pain, bloating, or changes in bowel habits occur when using psyllium While the evidence from studies on inflammatory bowel disease suggests that dietary fiber may be beneficial in maintaining remission in some patients with ulcerative colitis, but not in those with Crohn's disease 1, the primary concern for patients with diverticulitis is to manage their condition and prevent future complications. Psyllium works by adding bulk to stool and absorbing water, which can help regulate bowel movements and reduce pressure in the remaining colon, potentially preventing future diverticular complications by promoting softer, more regular bowel movements.
From the Research
Use of Psyllium Fiber Supplements in Patients with Diverticulitis
- The provided studies do not directly address the use of psyllium fiber supplements in patients with diverticulitis who have undergone partial colectomy.
- However, some studies suggest that a fiber-rich diet can be beneficial in reducing symptoms and preventing acute diverticulitis 2, 3.
- One study recommends a fiber-rich diet with 25-40 g/day of fiber for the prevention and nonpharmacological treatment of uncomplicated diverticular disease 3.
- Another study suggests that continuous fiber intake may improve symptoms and reduce diverticulitis recurrence 2.
- It is essential to note that the decision to use fiber supplements, including psyllium, should be individualized and based on the patient's specific condition and medical history.
- Patients with diverticulitis who have undergone partial colectomy should consult their healthcare provider to determine the best course of treatment and whether psyllium fiber supplements are suitable for their condition 4, 5.