Influence of inpatient dietary restriction on acute uncomplicated diverticulitis: A pilot observational study

Background: Despite the high prevalence of acute, uncomplicated diverticulitis there has been little original research regarding its dietary management upon presentation to acute care. Due to the lack of evidence and conflicting clinical guidelines, practice varies widely between physicians, but frequently involves a combination of bowel rest and liquid diets hypothesised to decrease patient symptoms and promote recovery. However, these dietary restrictions are not well evidenced and may increase patient burden and length of stay. Therefore, a prospective observational cohort study was undertaken to investigate the effect of inpatient dietary restriction on length of stay and 30-day diverticulitis reoccurrence in adults with acute, uncomplicated diverticulitis. Methods: Participants were recruited from patients admitted to Robina Hospital during the 14-week period from January to April 2017. Outcomes were compared for physician-prescribed liberalised (no dietary restrictions; n=11) versus restricted (bowel rest/nil by mouth or no solid foods allowed; n=16) inpatient diets. Results: Stepwise multiple linear regression found a liberalised diet decreased length of hospital stay by 1.1 days (P=0.035), after accounting for smoking status and gastrointestinal symptoms (GSRS score) at baseline. There were no statistically significant differences in reoccurrence, visits to general practitioner or gastrointestinal symptoms between groups at 30-days post discharge (P>0.05). Discussion: In acute, uncomplicated diverticulitis, a liberalised diet may be favourable to practitioners and patients compared to a restricted diet as it was associated with decreased length of stay. A randomised controlled trial is needed to strengthen confidence in the findings.