In the examination of the data fom January 2004 to June 2005 of 796 consecutive patients referred for total colonoscopy to 17 physicians included age, gender, presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding, showed that the prevalence of colonic diverticula increased from less than 10% in adults under 40 to about 75% in those over 75 years. Of these patients, nearly one third presented with right-sided involvement(1).
A. The do and do not’s list
1. Increase intake of vegetable
Vegetable intake, a strict vegetable diet, and increased fiber intake are associated with the decreased risk of diverticolosis(37).
2. Increased intake of nuts and corn
According to the study by the University of Washington School of Medicine, Harborview Medical Center, Seattle, cotrary to a long-standing belief, a large prospective study found that nuts and corn did not increase the risk of diverticulitis or diverticular bleeding(38).
3. Physical activity but not Vigorous activity
In the study of 47,228 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, found that physical activity lowers the risk of diverticulitis and diverticular bleeding. Vigorous activity appears to account for this association(39).
4. Lose weight
There is an associated of Diverticulitis with obese patients(40).
5. Stop smoking
Although there are conflict result in study, smoking is associated to Diverticulitis in some studies(41).
6. Avoid excessive drinking
Alcohol may increase the risk of asymptomatic diverticulosis and diverticulitis(42).
7. Reduced intake of carbohydrates
Epidemiologic studies have demonstrated an association between diverticulosis and diets that are low in fiber and high in refined carbohydrates(42a).
8. Avoid Low level of folate and vitamin B12
There is a report of an elderly man in whom hereditary spherocytosis (HS) had been diagnosed many years previously. He also had diverticulitis and was referred because of increasing anaemia (Hb 7.7 g/dl). He was suffering from diarrhoea and anorexia, and was taking a very poor diet. Serum investigations showed low folate and vitamin B12 levels, according to the Haematology Department, University Hospital(42b). Other study found that bacterial production of cobamides, both de novo and from ingested CN-Cbl bound to intrinsic factor, occurs in humans with bacterial overgrowth states and results in a significant loss of vitamin B12 to the host(42c).
9. Drink plenty of water to ease passage through the colon to prevent constipation of that may cause severity of the disease.
According to the study by Groote Schuur Hospital, South Africa, indicated that a weight loss of greater than 30% accompanying a variety of diseases was associated with a reduction in pancreatic enzyme secretion of over 80%, villus atrophy and impaired carbohydrate and fat absorption. Finally, specific nutrients can induce disease, for example, gluten-sensitive enteropathy, whilst dietary factors such as fibre, resistant starch, short-chain fatty acids, glutamine and fish-oils may prevent gastrointestinal diseases such as diverticulitis, diversion colitis, ulcerative colitis(43).
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