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The use of high dietary fibre intake and antibioticshave been hypothesised to play a role in the managementof diverticular disease; however, dietary recommendationsfor the prevention of diverticulitis in those with diverticulardisease are inconsistent and quality evidence is lacking.Therefore, this systematic review aimed to pool and appraiseexisting data to explore the effect of dietary fibre modificationswith or without antibiotics on the development of acutediverticulitis, gastrointestinal symptoms and bowel habits inadults with diverticular disease.
Five electronic databases were searched for studiesfrom database inception until March 2017. Studies werecritically appraised and pooled using meta-analysis.
20 studies were included. Compared with placebo,ispaghula husk supplementation significantly increaseddaily stool weight by μ42g/day (95%CI:26-57g; P
Dietary fibre supplementation may improvebowel function and gastrointestinal symptoms in thosewith diverticular disease; but its role in the preventionof diverticulitis is unknown. Although co-administrationwith poorly-absorbed antibiotics appears to have superioreffects compared to dietary fibre supplementation alone;recommendations for this are not supported due to the highrisk of bias in existing research.