An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study

Stam, M. A. W.; Draaisma, W. A.; Wall, Bryan J. M. van de; Bolkenstein, H. E.; Consten, Esther C. J.; Broeders, I. A. M. J.

doi:10.1111/codi.13505

Cited by 31 publications

(22 citation statements)

References 17 publications

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“…A retrospective study showed no increase in complications in a group of patients with a solid food diet compared to several types of dietary restrictions [96]. A prospective single-arm study with an unrestricted diet found an 8.1% complication rate after 6 months, which is comparable to rates in the literature on uncomplicated diverticulitis [97]. Additionally, a randomized trial found no increased pain scores, no increased length of hospital stay and no treatment failures in patients with an unrestricted oral regimen compared to an intravenous regimen including a minimum 24 h of fasting [98].…”

Section: Which Group Of Diverticulitis Patients Can Safely Be Treatedmentioning

confidence: 68%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

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184

177

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Aim The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.

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Section: Which Group Of Diverticulitis Patients Can Safely Be Treatedmentioning

confidence: 68%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

Self Cite

184

177

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“…A prospective, uncontrolled study of an unrestricted diet in 86 patients with uncomplicated diverticulitis concluded that this was well-tolerated, although 8% had serious adverse events and 20% had ongoing symptoms. 123 A multicenter trial is underway to evaluate an unrestricted vs a progressive diet in uncomplicated diverticulitis. Most guidelines do not address pain control.…”

Section: Pharmacologic Agentsmentioning

confidence: 99%

Epidemiology, Pathophysiology, and Treatment of Diverticulitis

2019

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“…Thus, any over‐ and under‐reporting of diverticular disease in the NPR will shift estimates in opposite directions. The study does not yield any information on the incidence of diverticular disease treated in an outpatient setting, or resolving without any contact with a healthcare facility. Incomplete coverage of the NPR before 1987 (approximately 60 per cent coverage in 1977 and 85 per cent in 1984) will have led to some recurrent cases being misclassified as incident, particularly at the start of the study.…”

Section: Discussionmentioning

confidence: 99%

Incidence and lifetime risk of hospitalization and surgery for diverticular disease

Sköldberg

Granlund

Discacciati

et al. 2019

British Journal of Surgery

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Background: Studies on incidence rates of first-time colonic diverticular disease are few, and population-based estimates of lifetime risk are lacking. In this observational study, the incidence, admission rates and lifetime risks of hospitalization and surgery for diverticular disease were investigated. Methods: Considering the entire Swedish population as an open cohort, incidence and admission rates, and lifetime risk estimates (considering death as a competing risk) of hospitalization and surgery for diverticular disease were calculated using data from cross-linked national registers and population statistics from 1987 to 2010.Results: In total, there were 144 107 hospital admissions for diverticular disease in 95 049 individual patients. Of these, 17 599 were admissions with bowel resection or stoma formation in 16 824 patients. The total number of person-years in the population during the study period was 213 949 897. Age-standardized incidence rates were 47⋅4 (95 per cent c.i. 47⋅1 to 47⋅7) for first-time hospitalization with diverticular disease and 8⋅4 (8⋅2 to 8⋅5) per 100 000 person-years for diverticular disease surgery. The corresponding admission rates (including readmissions) were 70⋅8 (70⋅4 to 71⋅2) and 8⋅7 (8⋅6 to 8⋅9) per 100 000 person-years. Following an increase in 1990-1994, rates stabilized. Based on incidence and mortality rates from 2000 to 2010, the estimated remaining lifetime risk of hospitalization from 30 years of age was 3⋅1 per cent in men and 5⋅0 per cent in women. The corresponding risk of surgery was 0⋅5 per cent in men and 0⋅8 per cent in women.Conclusion: Diverticular disease is a common reason for hospital admission, particularly in women, but rates are stable and the lifetime risk of surgery is low.

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An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study

Abstract: The incidence of complications among patients taking an unrestricted diet during an initial acute uncomplicated episode of diverticulitis was in line with that reported in the literature.

Cited by 31 publications

References 17 publications

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Epidemiology, Pathophysiology, and Treatment of Diverticulitis

Incidence and lifetime risk of hospitalization and surgery for diverticular disease

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