Physical Activity Decreases Diverticular Complications

Abstract

Objectives Little is known about the effect of physical activity on diverticular complications. This study examined prospectively the association between physical activity and diverticular bleeding and diverticulitis. Methods We studied 47,230 US males in the Health Professionals Follow-up Study cohort who were aged 40–75 years and free of diverticular disease, gastrointestinal cancer and inflammatory bowel disease at baseline in 1986. Men reporting newly diagnosed diverticular disease on biennial follow-up questionnaires were sent supplemental questionnaires outlining details of diagnosis and treatment. Physical activity was assessed every 2 years. Men recorded the average time per week spent in 8 recreational activities, and flights of stairs climbed per day. Cox proportional hazards regression was used to calculate relative risks. Results During 18 years of follow-up, 800 cases of diverticulitis, and 383 cases of diverticular bleeding were identified. Total cumulative physical activity was associated with a decreased risk of diverticulitis and diverticular bleeding. After adjustment for potential confounders, the relative risk (RR) for men in the highest quintile of total activity (≥57.4 Metabolic Equivalent (MET h/wk) was 0.75 (95% CI 0.58–0.95) for diverticulitis, and 0.54 (95% CI, 0.38–0.77) for bleeding when compared to men in the lowest quintile (≤8.2 MET h/wk). Vigorous activity was inversely related to diverticulitis (multivariable RR 0.66, 95% CI, 0.51–0.86), and bleeding (multivariable RR 0.61, 95% CI, 0.41 – 0.90) in a high vs. low comparison, whereas non-vigorous activity was not. These results were similar for recent (simple updated) and baseline activity. Conclusions Data from this large prospective cohort suggest that physical activity lowers the risk of diverticulitis and diverticular bleeding. Vigorous activity appears to account for this association.

Diverticulitis in immunosuppressed patients: A fatal outcome requiring a new approach?

“…Smoking and obesity are known to increase the incidence of diverticulitis and complicated diverticulitis [24][25][26][27] ; in contrast physical activity prevents diverticulitis and reduces the risk of complicated diverticulitis. 28,29 The effects of nutrition habits on diverticulitis are controversial. [30][31][32] In contrast to lifestyle changes, operative therapies for diverticulitis seem effective because they are independent of patients' compliance.…”

Blood flow in non-muscle tissues and organs during exercise: Nature of splanchnic and ocular circulation

“…It has been well established from large-population studies and meta-analyses that there is an inverse relationship between physical activity and the incidences of colorectal carcinoma, cancer, and diverticulitis 24,25) . Conversely, gastrointestinal symptoms are a well-known downside of exercise.…”

Changing Epidemiology: Does It Increase Our Understanding?

“…Further evidence comes from the American Healthcare Professionals Cohort Study, which reported a 1.78-fold (95% CI 1.08–2.94) increase in the risk of acute diverticulitis with obesity [17]. This link with obesity was also suggested by a 25% decrease in the risk of diverticulitis in those in this cohort who undertook vigorous physical activity compared to those that did not [18]. Reported associations of an increased risk of acute diverticulitis include use of aspirin, non-steroidal anti-inflammatory agents and alcohol [19,20].…”