General management of diverticular disease
Patients with diverticular disease are often encouraged to consume a high-fibre diet and increase their fluid intake. This may reduce symptoms, but there is no evidence that it reduces the formation of further diverticula. In some patients, a high-fibre diet may increase abdominal pain and bloating; it should not be continued if symptoms worsen. No evidence supports avoiding pips, nuts and seeds in the dietStrate, 2008Tursi, 2014.
Studies have indicated that the most likely cause of diverticulitis is impacted faecal matter (rather than food) in diverticula. Therefore the main strategy to prevent diverticulitis is to maintain a soft stool (see Management of functional constipation in adults).
The use of probiotics, rifaximin or mesalazine to prevent recurrence of diverticulitis is not recommended as it is not supported by evidenceHall, 2020Carter, 2017.
For management of patients with infection, see Diverticulitis. For management of patients with bleeding, see Diverticular bleeding.