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 >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.