Primary and secondary prevention of diverticular disease

Aldoori, Walid

doi:10.1007/1-4020-4318-x_23

Cited by 3 publications

(1 citation statement)

References 77 publications

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“…Relevant evidence indicates that dietary fiber, especially the insoluble fiber found mostly in fruits and vegetables, decreases the risk of diverticula development (51). The protective effect of dietary fiber would make stools bulkier, which would increase the size of the colon, lower intraluminal pressures, and shorten the time it takes for the colon to move (52).…”

Section: Most Diverticulosis Cases Remain Asymptomatic: Only About 4%...mentioning

confidence: 99%

Preventing acute diverticulitis. any roles for non-absorbable antibiotics? in search of evidence: a systematic review, meta-analysis, and trial sequential analysis

Koch

Maraolo

Natoli

et al. 2023

Front. Gastroenterol.

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BackgroundHospital admissions for diverticulitis, a complication of diverticular disease, are very much on the increase. Prevention of diverticulitis could cut costs and save lives.AimsTo identify whether the risk of the first episode of diverticulitis (primary prevention) or recurrence of diverticulitis (secondary prevention) can be reduced in patients with diverticular disease using non-absorbable antibiotics (mainly rifaximin).MethodsThe studies were identified by searching PubMed and CENTRAL from 1990 to May 2022. The methodological quality of each study was also evaluated. The outcome of the meta-analysis was the occurrence of a first or subsequent episode of diverticulitis. In addition, a trial sequential analysis was performed to evaluate whether the results would be subject to type I or type II errors.ResultsPrimary prevention: the risk difference was statistically significant in favor of rifaximin (-0,019, or -1.9%, CI -0,6 to -3,3%). There was no evidence of heterogeneity (I2 0%). At one year, two years, and eight years of age, the NNT was 62, 52, and 42, respectively. The level of evidence had a moderate degree of certainty. Secondary prevention: the risk difference was statistically significant in favor of rifaximin (- 0,24, or -24%, CI -47 to -2%). There was evidence of heterogeneity (I2 92%); NNT resulted in 5. The grade level was low.ConclusionsRifaximin can lower the risk of a first episode of diverticulitis. However, the cost-benefit ratio currently appears too high. Rifaximin could also reduce the risk of a second episode, but the quality of the evidence is low.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022379258.

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Section: Most Diverticulosis Cases Remain Asymptomatic: Only About 4%...mentioning

confidence: 99%

Preventing acute diverticulitis. any roles for non-absorbable antibiotics? in search of evidence: a systematic review, meta-analysis, and trial sequential analysis

Koch

Maraolo

Natoli

et al. 2023

Front. Gastroenterol.

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Treatment algorithms for diverticulitis

Kruis¹,

Böhm²,

Leifeld³

2009

Intestinal Disorders

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Moderne Therapie der Divertikelkrankheit

Leifeld

Kruis

2008

Internist

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New concepts are developed in the therapy of diverticular disease. 5-aminosalicylates can be administered in patients with slight forms of diverticulitis. In moderate diverticulitis antibiotics should be applied alternatively or additionally. In cases of severe diverticulitis patients should be kept fasting with parenteral nutrition and intravenous broad spectrum antibiotics. Small abscesses can be treated conservatively while abscesses larger than 4 cm should be drained in a first step and than treated surgically. A free perforation is still an absolute indication for emergency operation. In recurring diverticulitis indication for resection of the affected segment of the bowel should be considered depending on the extent of former attacks.

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Primary and secondary prevention of diverticular disease

Cited by 3 publications

References 77 publications

Preventing acute diverticulitis. any roles for non-absorbable antibiotics? in search of evidence: a systematic review, meta-analysis, and trial sequential analysis

Preventing acute diverticulitis. any roles for non-absorbable antibiotics? in search of evidence: a systematic review, meta-analysis, and trial sequential analysis

Treatment algorithms for diverticulitis

Moderne Therapie der Divertikelkrankheit

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