Likely to be beneficial

• The use of Rifaxamin with glucomannan or glucomannan alone.

One RCT found that oral Rifaxamin with glucomannan versus glucomannan plus a placebo significantly increases the proportion of patients with uncomplicated diverticular disease who are symptom free after 12 months of treatment.

Unknown effectiveness

• Two small RCTs found no consistent effect of bran or isphagula husk versus placebo on symptom relief after 12-16 weeks.

• There are no RCTs of elective or laparoscopic colonic resection.

• One RCT found no significant difference with lactulose versus high-fibre diet in the number of people who considered themselves to be much improved after 12 weeks.

• One small RCT found no significant difference with methylcellulose versus placebo in mean symptom score after 3 months.

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