31 March 2010

Managing Diverticulitis After Treatment

It is well documented that a diet low in insoluble fiber is considered the main etiological factor in leading to diverticulitis. The intake of insoluble fiber speeds up transit of food and increases bulk reducing pressure on the intestine (1). On the other hand, intake of red meat appears to increase risk (1).

Patients treated for diverticulits are often prescribed antibiotic therapy and recommended to stay on a low-fiber diet and reintroducing insoluble fiber gradually (2). In some cases, surgery is needed (2). Afterward, nutritionists would recommend gradual increases of fiber because a diet high in fiber can lead to high amounts of gas and forceful diarrhea (2-3).

Because of possible damage in the intestine, nutritionists should also evaluate patients are at higher risk of malnutrition. Malnutrition can lead to slow healing and recovery as well as deterioration of muscle, respiratory and immune function (4). To receive adequate nutrients, higher protein intake as well as supplements of certain vitamins such as B12 and minerals such as calcium may be needed (4).

A weight-management program may help to avoid diverticulitis in the future. According to a prospective cohort study, subjects with a BMI, waist circumference and waist-to-hip ratio that categorized them as obese had an increased risk of diverticulitis and diverticular bleeding (5).

Nutritionists may also recommend probiotics along with prebiotics to support growth of healthy intestinal flora after antibiotic therapy (4).

References

1. Korzenik JR. Case closed? Diverticulits: epedemiology and fiber. J Clin Gastroeneterol. 2006 Aug;40 Suppl 3:S1 12-6.
2. Kotzampassakis N, Pittet O, Schmidt S, Denys A, Demarines N, Calmes JM. Presentation and treatment outcome of diverticulitis in younger adults: a different disease than in older patients? Dis Colon Rectum. 2010 Mar;53(3):333-8.
4. Kohlstadt I. Food and Nutrients in Disease Management. Boca Raton, FL: CRC Press, 2009.
5. Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL. Obesity increases the risks of diverticulitis and diverticular bleeding 2008;136(1):115-112.

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