scholarly journals Progress and challenges in the management of diverticular disease: which treatment?

2018 ◽  
Vol 11 ◽  
pp. 175628481878905 ◽  
Author(s):  
Angel Lanas ◽  
Daniel Abad-Baroja ◽  
Aitor Lanas-Gimeno
Keyword(s):  
Disease Progression ◽  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Low Grade ◽  
High Fiber ◽  
Fiber Diet ◽  
Rising Incidence ◽  
High Fiber Diet ◽  
Open Versus ◽  
Low Grade Inflammation

Diverticular disease of the colon (DDC) includes a spectrum of conditions from asymptomatic diverticulosis to symptomatic uncomplicated diverticulosis, segmental colitis associated with diverticulosis, and acute diverticulitis without or with complications that may have serious consequences. Clinical and scientific interest in DDC is increasing because of the rising incidence of all conditions within the DDC spectrum, a better, although still limited understanding of the pathogenic mechanisms involved; the increasing socioeconomic burden; and the new therapeutic options being tested. The goals of treatment in DDC are symptom and inflammation relief and preventing disease progression or recurrence. The basis for preventing disease progression remains a high-fiber diet and physical exercise, although evidence is poor. Other current strategies do not meet expectations or lack a solid mechanistic foundation; these strategies include modulation of gut microbiota or dysbiosis with rifaximin or probiotics, or using mesalazine for low-grade inflammation in uncomplicated symptomatic diverticulosis. Most acute diverticulitis is uncomplicated, and the trend is to avoid hospitalization and unnecessary antibiotic therapy, but patients with comorbidities, sepsis, or immunodeficiency should receive broad spectrum and appropriate antibiotics. Complicated acute diverticulitis may require interventional radiology or surgery, although the best surgical approach (open versus laparoscopic) remains a matter of discussion. Prevention of acute diverticulitis recurrence remains undefined, as do therapeutic strategies. Mesalazine with or without probiotics has failed to prevent diverticulitis recurrence, whereas new studies are needed to validate preliminary positive results with rifaximin. Surgery is another option, but the number of acute events cannot guide this indication. We need to identify risk factors and disease progression or recurrence mechanisms to implement appropriate preventive strategies.

scholarly journals Role of Inflammation in the Pathogenesis of Diverticular Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio Tursi ◽  
Walter Elisei
Keyword(s):  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Human Colon ◽  
Recurrent Abdominal Pain ◽  
Preliminary Evidence ◽  
Low Grade ◽  
Symptom Persistence ◽  
Uncomplicated Diverticular Disease ◽  
Low Grade Inflammation

Diverticulosis of the colon is the most common condition in Western societies and it is the most common anatomic alteration of the human colon. Recurrent abdominal pain is experienced by about 20% of patients with diverticulosis, but the pathophysiologic mechanisms of its occurrence are not completely understood. In the last years, several fine papers have showed clearly the role of low-grade inflammation both in the occurrence of symptoms in people having diverticulosis, both in symptom persistence following acute diverticulitis, even if the evidence available is not so strong. We do not know yet what the trigger of this low-grade inflammation occurrence is. However, some preliminary evidence found colonic dysbiosis linked to low-grade inflammation and therefore to symptom occurrence in those patients. The aim of this paper is to summarize current evidences about the role of inflammation in symptom occurrence in symptomatic uncomplicated diverticular disease and in symptom persistence after an episode of acute diverticulitis.

scholarly journals Current and Evolving Concepts on the Pathogenesis of Diverticular Disease

2019 ◽  
Vol 28 ◽  
pp. 225-235 ◽  
Author(s):  
Antonio Tursi
Keyword(s):  
Diverticular Disease ◽  
Current Knowledge ◽  
Acute Diverticulitis ◽  
Colonic Motility ◽  
Human Colon ◽  
Recurrent Abdominal Pain ◽  
Low Grade ◽  
Host Immune Responses ◽  
Low Grade Inflammation

Background & Aims: Diverticulosis of the colon is the most common anatomic alteration of the human colon, and it is characterized by the out-pouching of the colonic mucosa and submucosa through the muscular layer. Recurrent abdominal pain is experienced by about 20% of patients with diverticulosis, and inflammation of diverticula may lead to acute diverticulitis. In the past few years, several studies have investigated the factors predisposing or triggering diverticular disease (DD) occurrence. Moreover, new physiopathological knowledge has been acquired. The aim of this study was to review current knowledge regarding the pathogenesis of DD. Methods: A search of PubMed and EMBASE database was performed to identify articles relevant to the pathogenesis of DD. Results: Several papers have shown that genetic predisposition, environmental factors, and colonic dysmotility are implicated in the pathogenesis of DD. More recent studies have associated specific host immune responses, gut microbiota imbalance and therefore low-grade inflammation as contributors to symptom occurrence in DD and diverticulitis. Conclusions: Current and evolving evidence highlighted the role of genetic susceptibility, environment, colonic motility, visceral sensitivity, immune response, and microbiota in the pathogenesis of this disease. Further studies are required to identify potential targets for medical or surgical decision-making.

P063 A COMPREHENSIVE, MULTIOMIC DIET INTERVENTION STUDY COMPARING A LOW FAT, HIGH FIBER DIET TO AN IDEALIZED STANDARD AMERICAN DIET IN ULCERATIVE COLITIS PATIENTS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S8-S9
Author(s):  
Julia Fritsch ◽  
Alejandra Quintero ◽  
Judith Pignac-Kobinger ◽  
Luis Garces ◽  
Ana Santander ◽  
...  
Keyword(s):  
Quality Of Life ◽  
High Fat Diet ◽  
High Fat ◽  
Dietary Interventions ◽  
Low Fat ◽  
High Fiber ◽  
Fiber Diet ◽  
Omega 6 ◽  
High Fiber Diet

Abstract Background and Aims There is a lack of evidence-based dietary interventions in ulcerative colitis (UC) management. A diet high in fat and animal meat has been linked to an increased risk of UC. The aim of our study was to use a multilayered, multi-omic approach to comprehensively characterize the effect of a low fat, high fiber diet or a high fat diet in UC patients. Methods We enrolled patients with UC who were in remission or had mild disease with a flare within the last 18 months. We used a cross-over design in which patients received two dietary interventions: a low fat diet (LFD), containing 10% total calories from fat with an omega 6 to 3 ratio of below 3:1, and an idealized standard American diet (SAD), containing 35–40% total calories from fat with an omega 6 to 3 ratio of 20–30:1. Each diet was four weeks long with a two-week wash-out in between. The diet was catered and delivered to patients’ homes. Clinical symptoms, quality of life, and biochemical data were collected. Stool was collected for microbiome and metabolomic analyses. The primary endpoint was to determine adherence to a specified diet using catered meals; the secondary endpoint was to determine the clinical and subclinical effects of a low fat, high fiber diet or high fat diet in UC. Results Baseline diets varied widely but were generally lower in fiber as well as fruits and vegetables and higher in saturated fat than either of the study diets. There was a high rate of adherence to catered meals (SAD=86.68%, LFD=84.8%) with a 96.8% and 94.33% adherence to fat for SAD and LFD respectively. Patients that started in remission remained in remission (partial Mayo and sIBDQ). Following a LFD, patients saw a 20% improvement in their quality of life as measured by sIBDQ compared to their baseline. The effect of diet intervention on microbial diversity was reflected in the beta diversity with a significant increase in Faecalibacterium prausnitzii after LFD. CRP, sIBDQ, IL-6, and IL1β had a significant effect on overall gut microbiota composition as measured by Bray Curtis beta diversity (PERMANOVA)(P<0.007, P<0.001, P<0.021, P<0.048 respectively). The top taxa that contributes the most to this microbial variation from these clinical parameters was Faecalibacterium prausnitzii. Patients following a SAD had an increase in lauric acid, myristic acid, and N-oleoyl-L-phenylalanine with an increase in omega-6 metabolism pathways. Patients following a LFD had higher glycine, alanine, and phenyllactic acid with omega 3 metabolism pathways increased after LFD. Conclusions A low fat, high fiber diet is well tolerated and did not increase biochemical markers of inflammation. Catered meals and collection of microbiome, metabolome and biochemical data may allow early stratification of diet responders.

scholarly journals High-fiber diet in the control of diabetes in rats.

1980 ◽  
Vol 27 (2) ◽  
pp. 169-173 ◽  
Author(s):  
SONO YAMASHITA ◽  
KAMEJIRO YAMASHITA ◽  
HIROKO YASUDA ◽  
ETSURO OGATA
Keyword(s):  
High Fiber ◽  
Fiber Diet ◽  
Control Of Diabetes ◽  
High Fiber Diet

High Fiber Diet in Hyperlipemia

JAMA ◽  
1978 ◽  
Vol 240 (3) ◽  
pp. 223 ◽  
Author(s):  
P. J. Palumbo
Keyword(s):  
High Fiber ◽  
Fiber Diet ◽  
High Fiber Diet

High fiber diet reduces stereotypic behavior of gilts but does not affect offspring performance

2021 ◽  
Vol 243 ◽  
pp. 105433
Author(s):  
Thiago Bernardino ◽  
Patricia Tatemoto ◽  
José Evandro de Moraes ◽  
Beatrice Morrone ◽  
Adroaldo José Zanella
Keyword(s):  
Stereotypic Behavior ◽  
Offspring Performance ◽  
High Fiber ◽  
Fiber Diet ◽  
High Fiber Diet

PSIX-5 Diet is more powerful than age in shaping the rumen bacterial community and function of dairy cattle

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 444-444
Author(s):  
YangYi Hao ◽  
Shuai Huang ◽  
Shengli Li
Keyword(s):  
Bacterial Community ◽  
Dairy Cattle ◽  
Rumen Fluid ◽  
Rumen Bacteria ◽  
Great Ability ◽  
Linear Discriminant ◽  
High Fiber ◽  
Fiber Diet ◽  
High Fiber Diet ◽  
And Function

Abstract The objective was to understand the effects of diet and age on the rumen bacterial community and function, 48 dairy cattle were selected. Rumen fluid samples were collected from each animal at 1.5 (1.5M, milk and starter diet, n=8), 6 (6M, starter and oat grass, n=8), 9 (9M, high fiber diet, n=8), 18 (18M, high fiber diet, n=8), 23 (23M, high fiber diet, n=8) and 27 (27M, high grain diet, n=8) months old. The acetate/propionate ratio (A/P) at M9, M18, and M23 were significantly higher than M27 and M1.5 (P < 0.05), while the A/P at M6 was lower than others (P < 0.05). The total volatile fatty acid at M23 and M27 was higher than others (P < 0.05). The urease at M18 was significantly lower than M1.5, M6, and M9 (P < 0.05), and the xylanase at M18 was significantly higher than M1.5, M23, and M27 (P < 0.05). 16S rRNA sequencing data and the Linear discriminant analysis showed that thirty-three bacteria were identified as biomarkers among ages and diets. The age and diet contributed 7.98% and 32.49% to the rumen bacteria community using the variation partitioning approach analysis. The norank_f_p-251-o5 was significantly and positively correlated with age (r = 0.83, P < 0.01), while Eubacterium was significantly and negatively correlated with age (r = -0.84, P < 0.01). Dietary fiber showed a strong correlation (r > 0.80, P < 0.01) with Lachnospiraceae, NK4A214_group, Saccharofermentans, Clostridia, Pseudobutyrivibrio Bacteroidales_UCG-001. These genera also negatively correlated with dietary crude protein and starch (r < - 0.80, P < 0.01). All these bacteria were significantly correlated with A/P, acetate, and urease (r > 0.5, P < 0.05). These findings collectively indicated that diet drives the great ability to shape the rumen bacteria community and function than age.

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