Roberson Jeffrey L, Pettke Erica N
Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Division of Colon and Rectal Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Pennsylvania.
Clin Colon Rectal Surg. 2024 Oct 4;38(4):253-256. doi: 10.1055/s-0044-1791552. eCollection 2025 Jul.
The incidence of diverticulosis continues to rise throughout western nations with collateral increases in the frequency of diverticulitis. However, the mechanism behind the transition from asymptomatic diverticulosis to complicated diverticulitis is incompletely understood. Dietary intake has long been investigated as one of, if not the main, links in the continuum of disease. As the world's diet continues to evolve with increasingly prevalent processed and high-fat food, longitudinal studies have emerged with a goal of finally explaining how diet influences the development of diverticulitis. While low-fiber, high-fat diets are believed to play a role in the development of an index episode of diverticulitis, the role in recurrent disease remains uncertain. More recent avenues of interest include the role of the microbiome, probiotics, and adjunct treatments such as 5-ASA and rifaximin. While robust longitudinal studies have identified an association between low-fiber, high-fat diets and the development of index diverticulitis, the impact of dietary composition and modification on disease recurrence remains unclear and fails to meet the threshold for societal recommendations.
在西方国家，憩室病的发病率持续上升，憩室炎的发病频率也随之增加。然而，从无症状憩室病转变为复杂性憩室炎背后的机制尚未完全明确。长期以来，饮食摄入一直被视为疾病连续过程中的一个环节，即便不是主要环节。随着全球饮食结构不断演变，加工食品和高脂肪食品日益普遍，纵向研究应运而生，旨在最终解释饮食如何影响憩室炎的发展。虽然低纤维、高脂肪饮食被认为在憩室炎首发发作的发展中起作用，但在复发性疾病中的作用仍不确定。最近更受关注的领域包括微生物群、益生菌的作用，以及诸如5-氨基水杨酸和利福昔明等辅助治疗。虽然有力的纵向研究已确定低纤维、高脂肪饮食与首发憩室炎的发展之间存在关联，但饮食组成和调整对疾病复发的影响仍不明确，且未达到社会推荐的阈值。
