Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease: A systematic literature review and mata-analysis

Megan Crichton, Camilla Dahl, Julie Jenkins-Chapman, Romina Nucera, Wolfgang Marx, Hannah Mackay, Skye Marshall

Research output: Contribution to conferencePosterResearch

7 Downloads (Pure)

Abstract

Background: The use of high dietary fibre intake and antibiotics have been hypothesised to play a role in the management of diverticular disease; however, dietary recommendations for the prevention of diverticulitis in those with diverticular disease are inconsistent and quality evidence is lacking. Therefore, this systematic review aimed to pool and appraise existing data to explore the effect of dietary fibre modifications with or without antibiotics on the development of acute diverticulitis, gastrointestinal symptoms and bowel habits in adults with diverticular disease. Methods: Five electronic databases were searched for studies from database inception until March 2017. Studies were critically appraised and pooled using meta-analysis. Results: 20 studies were included. Compared with placebo, ispaghula husk supplementation significantly increased daily stool weight by μ42g/day (95%CI:26-57g; P<0.00001); however, dietary fibre supplementation inconsistently improved gastrointestinal symptoms and transit times depending on baseline values, and no studies evaluated its role in preventing diverticulitis. Seven days to everyday per month for 12-24-months of dietary fibre supplementation had a 2.6 (95%CI:1.24-5.6; P=0.01) higher relative risk of diverticulitis compared to dietary fibre and poorly-absorbed antibiotic coadministration. Seven days every month for 12-24-months or 14 days of dietary fibre and poorly-absorbed antibiotic co-administration significantly decreased gastrointestinal symptoms compared with dietary fibre supplementation alone by a standardised mean of 1 point (scale of 0 to approximately 18) (95%CI:0.70-1.21; P<0.00001). Conclusions: Dietary fibre supplementation may improve bowel function and gastrointestinal symptoms in those with diverticular disease; but its role in the prevention of diverticulitis is unknown. Although co-administration with poorly-absorbed antibiotics appears to have superior effects compared to dietary fibre supplementation alone; recommendations for this are not supported due to the high risk of bias in existing research.
Original languageEnglish
Publication statusPublished - Nov 2017
Event43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition: Collaboration in Clinical Nutrition – Evidence Based Nutrition for Improving Patient Outcomes - Royal Pines Conference Centre, Gold Coast, Australia
Duration: 16 Nov 201718 Nov 2017
Conference number: 43rd

Conference

Conference43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition
Abbreviated titleAuSPEN 2017
CountryAustralia
CityGold Coast
Period16/11/1718/11/17

Fingerprint

Diet Therapy
Diverticulitis
Dietary Fiber
Anti-Bacterial Agents
Dietary Supplements
Psyllium
Databases
Gastrointestinal Transit
Habits
Meta-Analysis
Placebos
Weights and Measures

Cite this

Crichton, M., Dahl, C., Jenkins-Chapman, J., Nucera, R., Marx, W., Mackay, H., & Marshall, S. (2017). Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease: A systematic literature review and mata-analysis. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.
Crichton, Megan ; Dahl, Camilla ; Jenkins-Chapman, Julie ; Nucera, Romina ; Marx, Wolfgang ; Mackay, Hannah ; Marshall, Skye. / Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease : A systematic literature review and mata-analysis. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.
@conference{0cd9f6c9c9134999a21cb00c6ccb825c,
title = "Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease: A systematic literature review and mata-analysis",
abstract = "Background: The use of high dietary fibre intake and antibiotics have been hypothesised to play a role in the management of diverticular disease; however, dietary recommendations for the prevention of diverticulitis in those with diverticular disease are inconsistent and quality evidence is lacking. Therefore, this systematic review aimed to pool and appraise existing data to explore the effect of dietary fibre modifications with or without antibiotics on the development of acute diverticulitis, gastrointestinal symptoms and bowel habits in adults with diverticular disease. Methods: Five electronic databases were searched for studies from database inception until March 2017. Studies were critically appraised and pooled using meta-analysis. Results: 20 studies were included. Compared with placebo, ispaghula husk supplementation significantly increased daily stool weight by μ42g/day (95{\%}CI:26-57g; P<0.00001); however, dietary fibre supplementation inconsistently improved gastrointestinal symptoms and transit times depending on baseline values, and no studies evaluated its role in preventing diverticulitis. Seven days to everyday per month for 12-24-months of dietary fibre supplementation had a 2.6 (95{\%}CI:1.24-5.6; P=0.01) higher relative risk of diverticulitis compared to dietary fibre and poorly-absorbed antibiotic coadministration. Seven days every month for 12-24-months or 14 days of dietary fibre and poorly-absorbed antibiotic co-administration significantly decreased gastrointestinal symptoms compared with dietary fibre supplementation alone by a standardised mean of 1 point (scale of 0 to approximately 18) (95{\%}CI:0.70-1.21; P<0.00001). Conclusions: Dietary fibre supplementation may improve bowel function and gastrointestinal symptoms in those with diverticular disease; but its role in the prevention of diverticulitis is unknown. Although co-administration with poorly-absorbed antibiotics appears to have superior effects compared to dietary fibre supplementation alone; recommendations for this are not supported due to the high risk of bias in existing research.",
author = "Megan Crichton and Camilla Dahl and Julie Jenkins-Chapman and Romina Nucera and Wolfgang Marx and Hannah Mackay and Skye Marshall",
year = "2017",
month = "11",
language = "English",
note = "43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition : Collaboration in Clinical Nutrition – Evidence Based Nutrition for Improving Patient Outcomes, AuSPEN 2017 ; Conference date: 16-11-2017 Through 18-11-2017",

}

Crichton, M, Dahl, C, Jenkins-Chapman, J, Nucera, R, Marx, W, Mackay, H & Marshall, S 2017, 'Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease: A systematic literature review and mata-analysis' 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia, 16/11/17 - 18/11/17, .

Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease : A systematic literature review and mata-analysis. / Crichton, Megan; Dahl, Camilla ; Jenkins-Chapman, Julie; Nucera, Romina; Marx, Wolfgang; Mackay, Hannah; Marshall, Skye.

2017. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.

Research output: Contribution to conferencePosterResearch

TY - CONF

T1 - Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease

T2 - A systematic literature review and mata-analysis

AU - Crichton, Megan

AU - Dahl, Camilla

AU - Jenkins-Chapman, Julie

AU - Nucera, Romina

AU - Marx, Wolfgang

AU - Mackay, Hannah

AU - Marshall, Skye

PY - 2017/11

Y1 - 2017/11

N2 - Background: The use of high dietary fibre intake and antibiotics have been hypothesised to play a role in the management of diverticular disease; however, dietary recommendations for the prevention of diverticulitis in those with diverticular disease are inconsistent and quality evidence is lacking. Therefore, this systematic review aimed to pool and appraise existing data to explore the effect of dietary fibre modifications with or without antibiotics on the development of acute diverticulitis, gastrointestinal symptoms and bowel habits in adults with diverticular disease. Methods: Five electronic databases were searched for studies from database inception until March 2017. Studies were critically appraised and pooled using meta-analysis. Results: 20 studies were included. Compared with placebo, ispaghula husk supplementation significantly increased daily stool weight by μ42g/day (95%CI:26-57g; P<0.00001); however, dietary fibre supplementation inconsistently improved gastrointestinal symptoms and transit times depending on baseline values, and no studies evaluated its role in preventing diverticulitis. Seven days to everyday per month for 12-24-months of dietary fibre supplementation had a 2.6 (95%CI:1.24-5.6; P=0.01) higher relative risk of diverticulitis compared to dietary fibre and poorly-absorbed antibiotic coadministration. Seven days every month for 12-24-months or 14 days of dietary fibre and poorly-absorbed antibiotic co-administration significantly decreased gastrointestinal symptoms compared with dietary fibre supplementation alone by a standardised mean of 1 point (scale of 0 to approximately 18) (95%CI:0.70-1.21; P<0.00001). Conclusions: Dietary fibre supplementation may improve bowel function and gastrointestinal symptoms in those with diverticular disease; but its role in the prevention of diverticulitis is unknown. Although co-administration with poorly-absorbed antibiotics appears to have superior effects compared to dietary fibre supplementation alone; recommendations for this are not supported due to the high risk of bias in existing research.

AB - Background: The use of high dietary fibre intake and antibiotics have been hypothesised to play a role in the management of diverticular disease; however, dietary recommendations for the prevention of diverticulitis in those with diverticular disease are inconsistent and quality evidence is lacking. Therefore, this systematic review aimed to pool and appraise existing data to explore the effect of dietary fibre modifications with or without antibiotics on the development of acute diverticulitis, gastrointestinal symptoms and bowel habits in adults with diverticular disease. Methods: Five electronic databases were searched for studies from database inception until March 2017. Studies were critically appraised and pooled using meta-analysis. Results: 20 studies were included. Compared with placebo, ispaghula husk supplementation significantly increased daily stool weight by μ42g/day (95%CI:26-57g; P<0.00001); however, dietary fibre supplementation inconsistently improved gastrointestinal symptoms and transit times depending on baseline values, and no studies evaluated its role in preventing diverticulitis. Seven days to everyday per month for 12-24-months of dietary fibre supplementation had a 2.6 (95%CI:1.24-5.6; P=0.01) higher relative risk of diverticulitis compared to dietary fibre and poorly-absorbed antibiotic coadministration. Seven days every month for 12-24-months or 14 days of dietary fibre and poorly-absorbed antibiotic co-administration significantly decreased gastrointestinal symptoms compared with dietary fibre supplementation alone by a standardised mean of 1 point (scale of 0 to approximately 18) (95%CI:0.70-1.21; P<0.00001). Conclusions: Dietary fibre supplementation may improve bowel function and gastrointestinal symptoms in those with diverticular disease; but its role in the prevention of diverticulitis is unknown. Although co-administration with poorly-absorbed antibiotics appears to have superior effects compared to dietary fibre supplementation alone; recommendations for this are not supported due to the high risk of bias in existing research.

UR - https://custom.cvent.com/FE8ADE3646EB4896BCEA8239F12DC577/files/54abd59a1e7d46839291a4ebb305f1e0.pdf

M3 - Poster

ER -

Crichton M, Dahl C, Jenkins-Chapman J, Nucera R, Marx W, Mackay H et al. Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease: A systematic literature review and mata-analysis. 2017. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.