An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study.
OBJECTIVE
The optimal diet for uncomplicated diverticulitis is unclear. Guidelines refrain from recommendation due to lack of objective information. The aim of the study was to determine whether an unrestricted diet during a first acute episode of uncomplicated diverticulitis is safe.


METHODS
A prospective cohort study was performed of patients diagnosed with diverticulitis for the first time between 2012 and 2014. Requirements for inclusion were radiologically proven modified Hinchey Ia/b diverticulitis, American Society of Anesthesiologists class I-III and the ability to tolerate an unrestricted diet. Exclusion criteria were the use of antibiotics and suspicion of inflammatory bowel disease or malignancy. All included patients were advised to take an unrestricted diet. The primary outcome parameter was morbidity. Secondary outcome measures were the development of recurrence and ongoing symptoms.


RESULTS
There were 86 patients including 37 (43.0%) men. All patients were confirmed to have taken an unrestricted diet. There were nine adverse events in seven patients. These consisted of readmission for pain (five), recurrent diverticulitis (one) and surgery (three) for ongoing symptoms (two) and Hinchey Stage III (one). Seventeen (19.8%) patients experienced continuing symptoms 6 months after the initial episode and 4 (4.7%) experienced recurrent diverticulitis.


CONCLUSIONS
The incidence of complications among patients taking an unrestricted diet during an initial acute uncomplicated episode of diverticulitis was in line with that reported in the literature.
Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
M A W
MA
Stam
Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
W A
WA
Draaisma
Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
B J M
BJ
van de Wall
Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
H E
HE
Bolkenstein
Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
E C J
EC
Consten
Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
I A M J
IA
Broeders
D000208:Acute Disease; D000328:Adult; D000368:Aged; D004032:Diet / Q000379:methods*; D004238:Diverticulitis / Q000178:diet therapy*; D004239:Diverticulitis, Colonic / Q000178:diet therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome
Diverticulitis; conservative management; diet; nutrition; uncomplicated diverticulitis