title: Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review.
abstract: Symptomatic uncomplicated diverticular disease (SUDD) is a syndrome characterized by recurrent abdominal symptoms in patients with colonic diverticula. There is some evidence that a high-fiber diet or supplemental fibers may reduce symptoms in SUDD patients and a high-fiber diet is commonly suggested for these patients. This systematic review aims to update the evidence on the efficacy of fiber treatment in SUDD, in terms of a reduction in symptoms and the prevention of acute diverticulitis. According to PRISMA, we identified studies on SUDD patients treated with fibers (PubMed and Scopus). The quality of these studies was evaluated by the Jadad scale. The main outcome measures were a reduction of abdominal symptoms and the prevention of acute diverticulitis. Nineteen studies were included, nine with dietary fiber and 10 with supplemental fiber, with a high heterogeneity concerning the quantity and quality of fibers employed. Single studies suggest that fibers, both dietary and supplemental, could be beneficial in SUDD, even if the quality is very low, with just one study yielding an optimal score. The presence of substantial methodological limitations, the heterogeneity of the therapeutic regimens employed, and the lack of ad hoc designed studies, did not permit a summary of the outcome measure. Thus, the benefit of dietary or supplemental fiber in SUDD patients still needs to be established.
authors.affiliation: Medical-Surgical Department of Clinical Sciences and Translational Medicine, University Sapienza, Via di Grottarossa 1035, 00189 Rome, Italy. mariliacarabotti@gmail.com.|Department of Internal Medicine and Medical Specialties, University Sapienza, Viale del Policlinico 155, 00161 Rome, Italy. mariliacarabotti@gmail.com.
authors.forename: Marilia
authors.initials: M
authors.lastname: Carabotti
authors.affiliation: Medical-Surgical Department of Clinical Sciences and Translational Medicine, University Sapienza, Via di Grottarossa 1035, 00189 Rome, Italy. bruno.annibale@uniroma1.it.
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
authors.affiliation: Department of Internal Medicine and Medical Specialties, University Sapienza, Viale del Policlinico 155, 00161 Rome, Italy. carola.severi@uniroma1.it.
authors.forename: Carola
authors.initials: C
authors.lastname: Severi
authors.affiliation: Medical-Surgical Department of Clinical Sciences and Translational Medicine, University Sapienza, Via di Grottarossa 1035, 00189 Rome, Italy. edith.lahner@uniroma1.it.
authors.forename: Edith
authors.initials: E
authors.lastname: Lahner
mesh_terms: D016208:Databases, Factual; D004043:Dietary Fiber / Q000008:administration & dosage*; D043963:Diverticulosis, Colonic / Q000178:diet therapy*; D006801:Humans; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic
keywords: dietary fiber; diverticular disease; supplemental fiber; symptomatic uncomplicated diverticular disease