From the Research
To manage constipation and prevent diverticulitis flares, it is recommended to increase fiber intake gradually to 25-30 grams daily through fruits, vegetables, and whole grains, while also staying well-hydrated with 8-10 glasses of water daily, as supported by the most recent and highest quality study 1. The relationship between constipation and diverticulitis is complex, with constipation often contributing to diverticulitis development. Key measures to manage constipation include:
- Increasing fiber intake to add bulk to stool, making it easier to pass
- Staying well-hydrated to keep stool soft
- Regular physical activity to stimulate bowel movements
- Avoiding straining during bowel movements and responding promptly to urges to defecate Over-the-counter options for managing constipation include:
- Psyllium fiber supplements (Metamucil, 1 tablespoon in water 1-2 times daily)
- Docusate sodium stool softeners (100mg twice daily)
- Osmotic laxatives like MiraLAX (17g in 8oz water daily) During acute diverticulitis, it is recommended to follow a clear liquid or low-fiber diet temporarily, then gradually reintroduce fiber as symptoms improve, as suggested by studies on the management of diverticulitis 2. However, recent evidence suggests that more frequent bowel movements may actually be a risk factor for diverticulitis, rather than a protective factor 3, which highlights the need for individualized management strategies. The efficacy and safety of over-the-counter therapies for chronic constipation have been evaluated in recent systematic reviews, providing evidence-based recommendations for treatment 4. Overall, managing constipation and preventing diverticulitis flares requires a comprehensive approach that incorporates dietary changes, lifestyle modifications, and, when necessary, over-the-counter therapies, with the goal of reducing morbidity, mortality, and improving quality of life.