Crichton, Megan

Dahl, Camilla

Jenkins-Chapman, Julie

Mackay, Hannah

Mahoney, Sophie

Marshall, Skye

Marx, Wolfgang

Nucera, Romina

English

Background:The use of dietary fibre manipulation, probiotics and antibiotics have been hypothesised to benefit the management of diverticular disease. However, dietary recommendations for the prevention of diverticulitis are inconsistent and quality evidence is lacking. This systematic review aimed to pool and appraise existing data to give recommendations for dietary fibre modifications with or without probiotics and/or antibiotics in adults for the prevention of diverticulitis.Methods:Five electronic databases were searched for studies from database inception until March 2017. Studies were critically appraised and pooled using meta analysis and overall quality of evidence was reviewed using GRADE to make recommendations.Results:A long-term high dietary fibre intake (meeting or exceeding the nationally recommended intake for gender and age) after an acute episode of uncomplicated diverticulitis has resolved is recommended to prevent reoccurrence (strong recommendation based on very low-quality evidence). In adults with diverticular disease and no previous history of diverticulitis, insufficient research exists to make recommendations for the use of dietary fibre alone to prevent diverticulitis. Co-administration of dietary fibre with antibiotics appears to have superior effects compared to dietary fibre supplementation alone; however, recommendations for this are not supported in this review due to the high risk of bias in existing research.Discussion:Further well conducted randomised controlled trials are required to strengthen recommendations

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Bond UniversityResearch RepositoryEvidence for dietary fibre modification for the prevention of diverticulitisCrichton, Megan; Dahl, Camilla ; Jenkins-Chapman, Julie; Nucera, Romina; Marx, Wolfgang;Mackay, Hannah; Mahoney, Sophie; Marshall, SkyePublished: 01/11/2017Document Version:Publisher's PDF, also known as Version of recordLink to publication in Bond University research repository.Recommended citation(APA):Crichton, M., Dahl, C., Jenkins-Chapman, J., Nucera, R., Marx, W., Mackay, H., ... Marshall, S. (2017). Evidencefor dietary fibre modification for the prevention of diverticulitis: A systematic literature review. 51-52. Abstractfrom The First Gold Coast Health Research Week Conference 2017, Gold Coast, Australia.General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright ownersand it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.For more information, or if you believe that this document breaches copyright, please contact the Bond University research repositorycoordinator.Download date: 10 May 2019IntroductionMethodsRecommendations Based on ResultsConclusionsStudy AimsMegan Crichton1,4, Camilla Dahl1, Julie Jenkins2, Romina Nucera2, Wolfgang Marx1,3, Sophie Mahoney1, Skye Marshall11 Faculty of Health Sciences & Medicine, Bond University, Australia2 Department of Nutrition and Dietetics, Robina Hospital, Australia3 School of Allied Health, La Trobe University, Australia4 Corresponding Author: Bond Institute of Health and Sport, 2 Promethean Way, Robina, Qld, 4226 Australia. mcrichton@bond.edu.au 0432 061 886DIVERTICULITISDietary Fibre for PreventionA Systematic Review and Meta-Analysis1. A high dietary fibre intake isbeneficial, however, there is ‘low’confidence in the body of evidencesupporting this.• Intervention and observational studies were searched for using five electronic databases from database inception up until 31st March 2017.• Study quality was assessed using the Cochrane risk of bias tool. Data was pooled via meta-analysis. The quality of the body of evidence was assessed via GRADE. Despite the belief that dietary fibre prevents diverticulosisand diverticulitis (diverticular disease), little evidenceexists examining this relationship.Therefore, there are no dietary management guidelinesfor the prevention of acute diverticulitis.A systematic review of the literature was undertaken tosynthesise and critically appraise existing evidence togive recommendations for dietary fibre modifications withor without probiotics and/or antibiotics in adults for theprevention of diverticulitis.1. A high dietary fibre intake isbeneficial, however, there is ‘low’confidence in the guiding body ofevidence2. Co-administration of a probioticor oral antibiotic in comparison todietary fibre alone, may bebeneficial, however, there is “verylow” confidence in the body ofevidence for this.1. A liberalised diet is recommended over a restricted dietary fibre diet as inpatient management (strong recommendation based on ‘very low’ quality of evidence).2. A high dietary fibre diet isrecommended as opposed to astandard or low dietary fibre dietfollowing resolution of an acuteepisode (strong recommendationbased on ‘very low’ quality ofevidence).In Populations with Diverticulitis:In Populations with Diverticulosis:In Healthy Populations:Recommendations have beenmade based on 28 studies located,most of which had moderate tohigh risk of bias.For all populations, a high dietary fibre intake in accordance with national gender and age specific dietary fibre intake guidelines is recommended to prevent diverticulitis occurrence and reoccurrence.The use of dietary fibre restrictions (e.g. bowel rest or fluid only diets) for adults with acute, uncomplicated diverticulitis may not be necessary.It is, however, important to note that patients with contraindicating comorbidities or symptoms should be supported with individualised nutrition recommendations. 

Evidence for dietary fibre modification for the prevention of diverticulitis: A systematic literature review

https://pure.bond.edu.au/ws/files/24926558/DIETARY_FIBRE_MODIFICATION_FOR_THE.pdf

Evidence for dietary fibre modification for the prevention of diverticulitis: A systematic literature review

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