Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review

Camilla Dahl, Megan Crichton, Julie Jenkins-Chapman, Romina Nucera, Sophie Mahoney, Skye Marshall

Research output: Contribution to conferencePosterResearch

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Abstract

Background: Due to a lack of evidence regarding the dietary
management of acute uncomplicated diverticulitis, practice
varies for discharge nutrition recommendations, and may
include modified dietary fibre diets, fibre supplementation,
and/or probiotic supplementation. However, these therapies
alone or in conjuction have not yet been sufficiently evaluated
for the prevention of diverticulitis recurrence and impact on
recovery; the lack of consistency may increase patient burden,
health care costs and decrease efficacy and adherence.
Therefore, this systematic review aims to review the evidence
and develop recommendations for dietary fibre modifications,
either alone or alongside probiotics, versus any comparator
on reoccurrence, gastrointestinal symptoms and health care
use for adults following an episode of acute, uncomplicated
diverticulitis.
Methods: Intervention and observational studies in any
language were located using five electronic databases up
until March 31st, 2017, using a combination of keywords and
controlled vocabulary. GRADE was used to evaluate the overall
quality of the evidence and to develop recommendations.
Results: Three studies were included which used dietary fibre
modifications and none used probiotic supplementation. Due
to lack of consistent reporting, data could not be pooled. There
was “very low” quality of evidence for using a high dietary
fibre diet or supplements as opposed to a standard or low
dietary fibre diet following resolution of an acute episode to
improve reoccurrence and gastrointestinal symptoms. GRADE
was used to develop clinical recommendations considering
existing and generalised evidence, safety, preferences of
stakeholders, and feasibility.
Conclusions: Health care providers should recommend a
long-term high dietary fibre intake (meeting or exceeding the
nationally recommended intake for gender and age) after the
acute episode of uncomplicated diverticulitis has resolved
(strong recommendation based on very low-quality evidence).
Further well conducted randomised controlled trials are
required.
Original languageEnglish
Publication statusPublished - 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

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Diet Therapy
Diverticulitis
Probiotics
Dietary Fiber
Diet
Vocabulary
Health Personnel
Health Care Costs
Observational Studies
Research Design
Randomized Controlled Trials
Databases
Safety
Recurrence
Health

Cite this

Dahl, C., Crichton, M., Jenkins-Chapman, J., Nucera, R., Mahoney, S., & Marshall, S. (2017). Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.
Dahl, Camilla ; Crichton, Megan ; Jenkins-Chapman, Julie ; Nucera, Romina ; Mahoney, Sophie ; Marshall, Skye. / Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.
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abstract = "Background: Due to a lack of evidence regarding the dietarymanagement of acute uncomplicated diverticulitis, practicevaries for discharge nutrition recommendations, and mayinclude modified dietary fibre diets, fibre supplementation,and/or probiotic supplementation. However, these therapiesalone or in conjuction have not yet been sufficiently evaluatedfor the prevention of diverticulitis recurrence and impact onrecovery; the lack of consistency may increase patient burden,health care costs and decrease efficacy and adherence.Therefore, this systematic review aims to review the evidenceand develop recommendations for dietary fibre modifications,either alone or alongside probiotics, versus any comparatoron reoccurrence, gastrointestinal symptoms and health careuse for adults following an episode of acute, uncomplicateddiverticulitis.Methods: Intervention and observational studies in anylanguage were located using five electronic databases upuntil March 31st, 2017, using a combination of keywords andcontrolled vocabulary. GRADE was used to evaluate the overallquality of the evidence and to develop recommendations.Results: Three studies were included which used dietary fibremodifications and none used probiotic supplementation. Dueto lack of consistent reporting, data could not be pooled. Therewas “very low” quality of evidence for using a high dietaryfibre diet or supplements as opposed to a standard or lowdietary fibre diet following resolution of an acute episode toimprove reoccurrence and gastrointestinal symptoms. GRADEwas used to develop clinical recommendations consideringexisting and generalised evidence, safety, preferences ofstakeholders, and feasibility.Conclusions: Health care providers should recommend along-term high dietary fibre intake (meeting or exceeding thenationally recommended intake for gender and age) after theacute episode of uncomplicated diverticulitis has resolved(strong recommendation based on very low-quality evidence).Further well conducted randomised controlled trials arerequired.",
author = "Camilla Dahl and Megan Crichton and Julie Jenkins-Chapman and Romina Nucera and Sophie Mahoney and Skye Marshall",
year = "2017",
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Dahl, C, Crichton, M, Jenkins-Chapman, J, Nucera, R, Mahoney, S & Marshall, S 2017, 'Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review' 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia, 16/11/17 - 18/11/17, .

Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review. / Dahl, Camilla ; Crichton, Megan; Jenkins-Chapman, Julie; Nucera, Romina; Mahoney, Sophie; 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 - Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review

AU - Dahl, Camilla

AU - Crichton, Megan

AU - Jenkins-Chapman, Julie

AU - Nucera, Romina

AU - Mahoney, Sophie

AU - Marshall, Skye

PY - 2017

Y1 - 2017

N2 - Background: Due to a lack of evidence regarding the dietarymanagement of acute uncomplicated diverticulitis, practicevaries for discharge nutrition recommendations, and mayinclude modified dietary fibre diets, fibre supplementation,and/or probiotic supplementation. However, these therapiesalone or in conjuction have not yet been sufficiently evaluatedfor the prevention of diverticulitis recurrence and impact onrecovery; the lack of consistency may increase patient burden,health care costs and decrease efficacy and adherence.Therefore, this systematic review aims to review the evidenceand develop recommendations for dietary fibre modifications,either alone or alongside probiotics, versus any comparatoron reoccurrence, gastrointestinal symptoms and health careuse for adults following an episode of acute, uncomplicateddiverticulitis.Methods: Intervention and observational studies in anylanguage were located using five electronic databases upuntil March 31st, 2017, using a combination of keywords andcontrolled vocabulary. GRADE was used to evaluate the overallquality of the evidence and to develop recommendations.Results: Three studies were included which used dietary fibremodifications and none used probiotic supplementation. Dueto lack of consistent reporting, data could not be pooled. Therewas “very low” quality of evidence for using a high dietaryfibre diet or supplements as opposed to a standard or lowdietary fibre diet following resolution of an acute episode toimprove reoccurrence and gastrointestinal symptoms. GRADEwas used to develop clinical recommendations consideringexisting and generalised evidence, safety, preferences ofstakeholders, and feasibility.Conclusions: Health care providers should recommend along-term high dietary fibre intake (meeting or exceeding thenationally recommended intake for gender and age) after theacute episode of uncomplicated diverticulitis has resolved(strong recommendation based on very low-quality evidence).Further well conducted randomised controlled trials arerequired.

AB - Background: Due to a lack of evidence regarding the dietarymanagement of acute uncomplicated diverticulitis, practicevaries for discharge nutrition recommendations, and mayinclude modified dietary fibre diets, fibre supplementation,and/or probiotic supplementation. However, these therapiesalone or in conjuction have not yet been sufficiently evaluatedfor the prevention of diverticulitis recurrence and impact onrecovery; the lack of consistency may increase patient burden,health care costs and decrease efficacy and adherence.Therefore, this systematic review aims to review the evidenceand develop recommendations for dietary fibre modifications,either alone or alongside probiotics, versus any comparatoron reoccurrence, gastrointestinal symptoms and health careuse for adults following an episode of acute, uncomplicateddiverticulitis.Methods: Intervention and observational studies in anylanguage were located using five electronic databases upuntil March 31st, 2017, using a combination of keywords andcontrolled vocabulary. GRADE was used to evaluate the overallquality of the evidence and to develop recommendations.Results: Three studies were included which used dietary fibremodifications and none used probiotic supplementation. Dueto lack of consistent reporting, data could not be pooled. Therewas “very low” quality of evidence for using a high dietaryfibre diet or supplements as opposed to a standard or lowdietary fibre diet following resolution of an acute episode toimprove reoccurrence and gastrointestinal symptoms. GRADEwas used to develop clinical recommendations consideringexisting and generalised evidence, safety, preferences ofstakeholders, and feasibility.Conclusions: Health care providers should recommend along-term high dietary fibre intake (meeting or exceeding thenationally recommended intake for gender and age) after theacute episode of uncomplicated diverticulitis has resolved(strong recommendation based on very low-quality evidence).Further well conducted randomised controlled trials arerequired.

M3 - Poster

ER -

Dahl C, Crichton M, Jenkins-Chapman J, Nucera R, Mahoney S, Marshall S. Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review. 2017. Poster session presented at 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.