Treatment of Symptomatic Diverticular Disease With a High-Fibre Diet

Brodribb, A. J. M.

doi:10.1016/s0140-6736(77)92112-2

Cited by 202 publications

(108 citation statements)

References 7 publications

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“…The duration of the placebo effect is not known, but the high response rates usually decrease as a trial extends to 2 or 3 months. 25,26 Thus, given the time span (total, 5 months) of this study, a placebo effect on the results appears less probable. The possibility of 'regression towards the mean' also needs to be considered.…”

Section: Discussionmentioning

confidence: 82%

Nutcracker oesophagus: a double‐blind, placebo‐controlled, cross‐over study of the effects of lansoprazole

Börjesson¹,

Rolny

Mannheimer³

et al. 2003

Aliment Pharmacol Ther

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SUMMARYBackground: Nutcracker oesophagus is characterized by high-amplitude oesophageal contractions. Recent data have shown a high prevalence of gastro-oesophageal acid reflux in patients with nutcracker oesophagus and, in open-label trials, patients seemed to benefit from acid suppression. Therefore, it has been suggested that noncardiac chest pain in patients with nutcracker oesophagus may be related to reflux rather than to the motor abnormality itself. Aims: To investigate the effect of intensive acid-suppressive treatment on chest pain in patients with nutcracker oesophagus. Methods: Nineteen patients with nutcracker oesophagus received lansoprazole or placebo in a double-blind, randomized, cross-over study.

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Section: Discussionmentioning

confidence: 82%

Nutcracker oesophagus: a double‐blind, placebo‐controlled, cross‐over study of the effects of lansoprazole

Börjesson¹,

Rolny

Mannheimer³

et al. 2003

Aliment Pharmacol Ther

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“…Long-term dietary intervention studies in man aimed at preventing the onset of diverticular disease are unfeasible; there have been intervention trials addressing the benefits of dietary fiber in preventing the complications of DD. These have had mixed success [68,69] and tell us little about disease etiology.…”

Section: Bread and Cereal Productsmentioning

confidence: 99%

Diet, ageing and genetic factors in the pathogenesis of diverticular disease

Commane¹,

Arasaradnam²,

Mills³

et al. 2009

WJG

119

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Diverticular disease (DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK. This high prevalence ranks it as one of the most common bowel disorders in western nations. The majority of patients remain asymptomatic but there are associated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum. Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality. In the 1970s, a model of DD formulated the concept that diverticula occur as a consequence of pressureinduced damage to the colon wall amongst those with a low intake of dietary fiber. In this review, we have examined the evidence regarding the influence of ageing, diet, inflammation and genetics on DD development. We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal. We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease.

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“…Per la cura di questa patologia è stato suggerito un ruolo terapeutico delle fibre: alcuni trial clinici controllati hanno dimostrato il beneficio ottenuto sul piano sintomatico dalla somministrazione di crusca e di altri agenti in grado di aumentare la massa fecale [7,8]; a fronte di questi primi risultati però non c'è stata la conferma da parte di altri studi svolti che, anzi, non hanno dimostrato nessuna differenza, in termini di outcome, tra l'utilizzo di tali sostanze e la somministrazione di placebo [9,10].…”

Section: O Zaniolo M Eandiunclassified

“…Questa sostanza è un polisaccaride (rientra tra le fibre alimentari) che, assorbendo più di cento volte il suo volume in acqua, aumenta la massa della feci e le rende meno compatte regolandone il transito intestinale; nel caso di diverticolosi, l'utilizzo di una dieta ad alto contenuto di fibre viene generalmente consigliato, sebbene gli studi randomizzati non abbiano ottenuto risultati omogenei a proposito degli effetti benefici di crusca e affini sui sintomi di tale patologia [31,32,7].…”

Section: Profilo Terapeutico Efficacia Clinicaunclassified

Rifaximina nel trattamento della malattia diverticolare: potenziale terapeutico ed economico

Zaniolo

Eandi

2005

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INTRODUZIONEIl termine "malattia diverticolare" si riferisce a un concetto clinico usato a proposito di pazienti affetti da diverticolosi, sia sintomatica che asintomatica [1]. La diverticolosi del colon è una patologia acquisita caratterizzata dalla formazione di un gran numero di estroflessioni sacciformi della parete dell'intestino, localizzate più frequentemente nel colon sinistro, e in particolare nel colon sigmoideo.Queste erniazioni, dette appunto diverticoli, sono in genere causate da un'esagerata pressione all'interno del lume intestinale (diverticolo da pulsione) o, in casi limitati, da un'aderenza infiammatoria tra un organo cavo e linfonodi vicini (diverticolo da trazione). Si Rifaximina nel trattamento della malattia diverticolare: potenziale terapeutico ed economico Orietta Zaniolo*, Mario Eandi* ABSTRACTAntibiotics are commonly used to treat major inflammatory complications of diverticular disease, but apparently there is no rationale for the use of antibiotic therapy in uncomplicated disease, where an inflammatory component is by definition excluded. Some observations suggest a possible role of gut microflora in determining some symptoms related to diverticular disease: bacterial overgrowth, amplifying gas production and bacterial degradation of fibres, could determine bloating, pain and high fecal density. Therefore a beneficial antibiotic action on diverticular disease symptoms can be hypothesized. In this paper pharmacokinetic, pharmacodinamic and therapeutic potential of an intestinal antibiotic, rifaximin, are reviewed. Rifaximin is a rifamycin derivative which acts by inhibiting bacterial ribonucleic acid (RNA) synthesis. It is virtually unabsorbed after oral administration and in vitro data indicate it to possess a broad spectrum of action; bacterial resistance during exposure to rifaximin has been reported but its clinical importance remains to be fully defined. The results of placebo-controlled clinical trials show that cyclic administration of rifaximin is more effective in reducing symptoms and in preventing complications than fibre supplementation alone; the drug appears to be well tolerated and safe. We consider the clinical implications and economical impact of diverticulosis on the Italian National Health System and the patient, with a particular attention on the cost of hospitalization, surgery and global management of diverticulitis and other common disease complications. The hypothetic savings correlated to the reduction of complications incidence, attainable with rifaximin use have been calculated and the comparison between the different acquisition costs of the drug frequently used to treat the diverticular disease is provided. Finally we reviewed some quality of life trials in which the psychological and sociological influence of the disease symptoms and treatments on the patient are assessed.Keywords: diverticular disease, rifaximin, antibiotics, economical impact Farmeconomia e percorsi terapeutici 2005; 6 (1): 5-20 PROFILO *Farmacologia Clinica, Università di Torino rit...

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Treatment of Symptomatic Diverticular Disease With a High-Fibre Diet

Cited by 202 publications

References 7 publications

Nutcracker oesophagus: a double‐blind, placebo‐controlled, cross‐over study of the effects of lansoprazole

Nutcracker oesophagus: a double‐blind, placebo‐controlled, cross‐over study of the effects of lansoprazole

Diet, ageing and genetic factors in the pathogenesis of diverticular disease

Rifaximina nel trattamento della malattia diverticolare: potenziale terapeutico ed economico

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