The symptoms of diverticular disease (DD) include “colicky, unexplained, recurrent, and short-lived but often debilitating abdominal pain and alteration in bowel habit.”

The following treatments have some foundation, but, have not been completely verified by placebo-controlled studies: dietary fiber, low absorption antibiotics, anti-inflammatory drugs (such as mesalazine) and probiotics (friendly bacteria.)

Dietary fibers protect us from our refined Western diets, with little fiber, reduced stool volumes and increased colonic pressures. Good fibers are wheat bran (24 g/day,) cellulose, pectins and gums. Soluble fibers, such as psyllium and glucomannon, are better tolerated than the insoluble fibers.

Poorly absorbed antibiotics reduce the bacterial breakdown of dietary fibers, make the fibers more tolerable (without gas and bloating) and increase the effectiveness of fibers. Fiber should be used continuously, even when the patient is asymptomatic.

Probiotics are given to correct the abnormal flora in the bowel associated with DD. The abnormal bacteria can damage the protective function of the lining of the bowel, which usually prevents dangerous bacteria from entering the blood stream. Probiotics can reduce the number of pathologic bacteria in the bowel.

CONCLUSION: Anti-inflammatory agents and probiotics taken together can make 96% of patients asymptomatic. A combination of poorly absorbed antibiotics and mesalazine can render 80% of patients asymptomatic. A combination of fibers (20 gm/day) and poorly absorbed antibiotics can cause 69% of patients to be asymptomatic. Fiber and antibiotics work better than fiber alone.

NOTE: Some of the above is from Sheth, A. (PMID: 19244147.)

To read the author’s abstract of the article click on the link to the author’s title of the article above.

Read about probiotics and diverticular disease.

PMID: 19652620.

Summary #407.