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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Classically, diverticular disease is believed to occur as a result of deficiency of dietary fibre. (1) Dietary fibre intake has been shown to be inversely associated with the risk of developing diverticular disease. Although dietary fibre may not prevent diverticulosis, it has been shown to play a role in preventing diverticular disease.

Vegetarians have been shown to have a lower incidence of diverticular disease (2). Right-sided diverticular disease, which is more common in Asia and specifically in younger people in Asia, is shown to be associated with meat consumption in Asian populations. (3)

Alongside aging, other risk factors for diverticulosis include:

  • diets high in red meat and fat
  • medications – NSAIDs, corticosteroids, opiates
  • obesity (4)
  • smokers relative to non-smokers (5)

Several protective factors have also been reported: (6)

  • vegetarian diets
  • increased physical activity
  • medications – calcium channel blockers and statins
  • higher vitamin D – reduces the risk of hospitalisation for diverticulitis

References:

  1. Simpson J, Scholefield JH, Spiller RC. Pathogenesis of colonic diverticula. Br J Surg 2002 May;89(5):546-54.
  2. Crowe FL, Appleby PN, Allen NE, et al. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ. 2011 Jul 19;343
  3. Imaeda H, Hibi T. The burden of diverticular disease and iIts complications: west versus east. Inflamm Intest Dis. 2018 Dec;3(2):61-8.
  4. Wijarnpreecha K, Ahuja W, Chesdachai S, et al. Obesity and the risk of colonic diverticulosis: a meta-analysis. 2018 Apr;61(4):476-83.
  5. Wijarnpreecha K, Boonpheng B, Thongprayoon C, et al. Smoking and risk of colonic diverticulosis: a meta-analysis. J Postgrad Med. 2018 Jan-Mar;64(1):35-9.
  6. Feuerstein JD, Falchuk KR. Diverticulosis and Diverticulitis. Mayo Clin Proc. 2016 Aug;91(8):1094-104

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