Canavan, Russell

Crichton, Megan

Dahl, Camilla

Dalwood, Phoebe

Eberhardt, Fiona

https://orcid.org/

Jenkins, Julie

Mahoney, Sophie

Marshall, Skye

Nucera, Romina

English

Queensland University of Technology ePrints Archive

Influence of Inpatient Dietary Restriction on Recovery from and Reoccurrence of Acute, Uncomplicated Diverticulitis

Rationale: Recent literature suggests that a liberalised diet (i.e. no dietary restrictions) is safe for the inpatient management of acute, uncomplicated diverticulitis; however, physicians internationally continue to prescribe restricted diets (i.e., nil per os or fluid-only diets for &gt;48 hours). This study aims to assess the impact of restricted versus liberalised inpatient dietary prescription on recovery and reoccurrence in adults with acute, uncomplicated diverticulitis. Methods: Prospective observational study of adult patients admitted to two metropolitan hospitals in Queensland, Australia from 2016 to 2019. Hierarchical multiple linear regression was used to determine the impact of restricted versus liberalised diets on length of hospital stay (i.e., time to recovery). Stepwise binomial logistic regression was used to determine the impact of restricted versus liberalised diets on 30-day reoccurrence of diverticulitis. Results: Of the 82 participants, 39 (64% female, mean age 57.6 ± 13.3 years, mean BMI 27.0 ± 4.3 kg/m2) were prescribed a restricted diet and 41 (49% female, mean age 58.1 ± 14.6 years, mean BMI 28.7 ± 4.8 kg/m2) were prescribed a liberalised diet. In the adjusted models, a liberalised diet decreased length of stay by 1.1 days (95%CI: −1.8 to −0.4; p = 0.004). At 30-days post-discharge, there were no dietary, gastrointestinal symptom, demographic, or medical characteristics which predicted reoccurrence. Conclusions: This study found that a liberalised diet for the management of acute, uncomplicated diverticulitis was associated with a shorter length of hospital stay compared to a restricted diet, and was not associated with diverticulitis reoccurrence. This study suggests a liberalised diet is safe, reduces burden on both the patient and the health care system, and may promote recovery from acute, uncomplicated diverticulitis

Bond University Research Portal

Bond UniversityResearch RepositoryInfluence of Inpatient Dietary Restriction on Recovery from and Reoccurrence of Acute,Uncomplicated DiverticulitisCrichton, Megan; Nucera, Romina; Jenkins, Julie; Canavan, Russell; Mahoney, Sophie;Eberhardt, Fiona; Dalwood, Phoebe; Dahl, Camilla ; Marshall, SkyePublished in:Clinical NutritionDOI:10.1016/S0261-5614(19)32194-6Published: 01/09/2019Document Version:Publisher's PDF, also known as Version of recordLink to publication in Bond University research repository.Recommended citation(APA):Crichton, M., Nucera, R., Jenkins, J., Canavan, R., Mahoney, S., Eberhardt, F., ... Marshall, S. (2019). Influenceof Inpatient Dietary Restriction on Recovery from and Reoccurrence of Acute, Uncomplicated Diverticulitis.Clinical Nutrition, 38(S1), S191. [MON-PO360]. https://doi.org/10.1016/S0261-5614(19)32194-6General 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: 17 Oct 2019The backgroundMegan Crichton Bond UniversityRomina NuceraGold Coast Health ServiceJulie Jenkins Gold Coast Health ServiceFiona Eberhardt Bond UniversitySophie Mahoney Bond UniversityPhoebe Dalwood Bond UniversityCamilla Dahl  Bond UniversityDr Russell Canavan Gold Coast Health ServiceDr Skye Marshall Bond UniversityThe purposeInfluence of inpatient dietary prescription on recovery from and reoccurrence of acute, uncomplicated diverticulitisA 3-year prospective cohort studyThis study aims to assess the impact of restricted versusliberalized inpatient dietary prescription on recovery from andreoccurrence of acute, uncomplicated diverticulitis.The methodsProspective observational study of adult patients admitted to two metropolitan hospitals in Queensland,Australia, from 2016-2019. Hierarchical multiple linear regression was used to determine the impact ofrestricted versus liberalized diets on hospital length of stay (a proxy for recovery). Binomial logisticregression was used to determine the impact of restricted versus liberalized diets on 30-day and 6-monthreoccurrence of diverticulitis.The participantsInternationally, physicians and surgeons continue to prescribe restricted diets for inpatient management of acute, uncomplicated diverticulitis. skye_marshall@bond.edu.au; @DrSkyeMarshall“Clear fluids for 24hrs then upgrade to full fluids for 24hrs, followed by a low-fibre diet until discharge”ab• 45% Restricted Diet• 55% Liberalised diet• 55% were prescribed≥3 different diet codesduring admission• 100% weredischarged ona “low dietaryfibre” diet• µ36± 19 (scale0-105, higherworse)Gastrointestinalsymptoms• 57% female• Age: µ59.0 ± 13.7yrs• BMI: µ27.8 ± 4.6kg/m2• Alcohol: µ1.4 ± 2.7 standard drinks/day• Admission bodytemp: µ36.9 (0.7)Celsius•34% admitted               with diarrhoea•31% admitted               with constipation•0% treatment           failureDietary prescription didn’t affect diverticulitis reoccurrence!Neither liberalized nor restricted diets were predictors of risk of diverticulitis reoccurrence at 30-days or 6-months post-discharge (p>0.05).The key messageThis study confirms and strengthens existing evidencea: Adult patients admitted to hospital with acute,uncomplicated diverticulitis (i.e. no perforation, non-localized abscess, drains placed or surgery required)should be placed on a liberalized diet (i.e., allowing consumption of solid food) and not placed on a restricteddiet (i.e., bowel rest/nil by mouth, clear or full fluids).In a model adjusted for patient characteristics, clinical presentation, and gastrointestinal symptoms, prescribing a liberalized diet decreased hospital length of stay (recovery) by 17 hours! (p<0.001)Prescribing a liberalized diet was associated with decreased hospital length of stay (indicator of recovery) by 28 hours! (p<0.001)a. Dahl, et al. Dietary fibre modification in the recovery and prevention of reoccurrence of acute, uncomplicated diverticulitis: a systematic review andmeta-analysis. Nutrients, 10(2), 137.b. Eberhardt, unpublished data, 2019.

https://pure.bond.edu.au/ws/files/32631222/Marshall_ESPEN_Diverticulitis_Cohort_Study_FINAL.pdf

Influence of Inpatient Dietary Restriction on Recovery from and Reoccurrence of Acute, Uncomplicated Diverticulitis

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