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Fiber and Diverticular Disease

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Dietary Fiber in Health and Disease

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Abstract

Diverticular disease is among the most clinically and economically significant gastroenterological conditions in people > 65 years of age. Most people > 65 years of age will develop colonic diverticulae (herniate pouches) potentially caused by high colon intraluminal pressure. While 80% of the population with colonic diverticula remain asymptomatic, approximately 20% may develop abdominal symptoms (symptomatic uncomplicated diverticular disease), and in some individuals there may be eventual complications such as severe bouts of diverticulitis or bleeding that may lead to sepsis and death.

In aging populations, the widespread intake of low fiber Western diets; increased intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) naturally from whole foods or added to processed foods; and weight gain leading to obesity are several factors that may increase the risk of diverticular disease, bouts of symptoms, or its complications.

Five prospective studies suggest that fiber-rich healthy diets and low red or processed meat consumption significantly decrease the risk of diverticular disease.

Although a number of intervention trials suggest that fiber-rich diets and foods or supplements containing wheat bran, psyllium, or methylcellulose may help to alleviate diverticular disease symptoms and/or improve bowel function, there are presently a limited number of high-quality trials.

Fiber-related mechanisms associated with potentially reduced diverticular disease risk or alleviation of symptoms are related to improved colonic health including improved laxation and stool bulk and a healthier microbiota ecosystem with higher fecal concentration of probiotic bacteria and butyrate, lower inflammation, and improved body weight and visceral fat regulation.

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    Mark L. Dreher

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Dreher, M.L. (2018). Fiber and Diverticular Disease. In: Dietary Fiber in Health and Disease. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-50557-2_8

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  • DOI: https://doi.org/10.1007/978-3-319-50557-2_8

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