Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Bulking agents, also known as fiber supplements (e.g., psyllium, methylcellulose), are commonly recommended for the management of diverticular disease, including diverticulitis, primarily after the acute phase has resolved. The rationale for their use is based on their ability to increase stool bulk and decrease colonic pressure, theoretically reducing the risk of further diverticular complications. Clinical guidelines, such as those from the American Gastroenterological Association, support the use of dietary fiber in patients with a history of diverticulitis to help prevent recurrence. Several observational studies and randomized controlled trials have shown that a high-fiber diet or fiber supplementation can reduce symptoms associated with diverticular disease, such as constipation and abdominal discomfort. However, the evidence is less clear regarding the prevention of recurrent acute diverticulitis, with some studies showing benefit and others showing no significant effect. Importantly, bulking agents are not recommended during acute diverticulitis flare-ups, as increased fiber intake can worsen symptoms during active inflammation. Overall, while there is scientific support for the use of bulking agents in the chronic management and symptom prevention of diverticular disease, the strength of evidence specifically for preventing recurrence of diverticulitis is moderate.

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