- Current evidence does not support restricted diet or bowel rest for patients with acute, uncomplicated diverticulitis.
- Authors conditionally recommend solid food for inpatients and strongly recommend a high-fiber diet after resolution, absent contraindications.
Why this matters
- Though “bowel rest” via food or fiber restriction is often recommended during acute diverticulitis, evidence suggests inefficacy and/or harm.
- Low-fiber diets and probiotics are often recommended upon symptom resolution, but recent reviews have not addressed this.
- Most studies had unclear or high bias risk in multiple domains.
- Liberalized vs low-fiber diets for acute episodes (5 studies):
- Length of stay (LOS): most found shorter LOS with liberalized diet;
- Recurrence (2 studies): no significant difference between groups;
- Treatment failure (3 studies): no significant difference between groups;
- For all above outcomes, results could not be pooled, evidence quality was very low.
- Modified diets after symptom resolution (3 studies): no conclusions; very low-quality evidence.
- Systematic review through March 2017.
- All participants were adults with acute, uncomplicated diverticulitis who undertook dietary interventions during or immediately after the episode.
- Primary outcome: hospital LOS.
- Funding: None.
- Few randomized controlled trials.
- Studies were heterogeneous, low quality.
- Recommendations do not come from a “robust multidisciplinary guideline panel.”