diverticular disease
Lecture-style review by Dr Jason A. Hawrelak (Probiotic Advisor) summarizing diverticular disease: definitions (diverticulosis, SUDD, diverticulitis, SCAD), proposed pathophysiology (age, genetics, low-fibre diet, dysbiosis, low-grade inflammation, altered motility), clinical spectrum and diagnostics (CT/US and classification systems), epidemiology (increasing incidence, age-related prevalence), associations (obesity, metabolic syndrome, CVD, anxiety/depression, IBS), modifiable risk factors (dietary patterns, physical activity, medications), and naturopathic/functional management strategies (Mediterranean/plant-based diet, increased fibre and resistant starch, prebiotics like lactulose, specific probiotics and herbal agents, butyrate supplementation, interventions for methane overproduction, and supportive measures). The document reviews trial evidence for dietary fibre, specific supplements/herbs, prebiotics, and multiple probiotic strains—overall advocating holistic risk reduction and selected adjunctive nutraceuticals.
Questions this document answers
30–39y: 5.3%; 40–49y: 8.7%; 50–59y: 19.4%; 70–79y: 40.2%; >80y: 57.9%.
SCAD prevalence: 0.25%–1.4% of the general population and 1.2%–11.4% of those with diverticular disease; mean age early–mid 60s; more common in males.
Estimated heritability: ~40–53% of individual risk.
Colonic diverticulosis RR=1.41 (95% CI 1.20–1.65); increased risk of diverticulitis RR=1.78 (95% CI 1.08–2.94) and diverticular bleeding RR=3.19 (95% CI 1.45–7.00).
Highest vs lowest fibre quintile multivariable HR for diverticulitis = 0.86 (95% CI 0.78–0.95) for total fibre (with subresults for cereal, fruit, vegetable fibre varying).