Debunking Myths About Diverticular Disease
Debunking Myths About Diverticular Disease
Myth number 3 is that in patients with diverticulosis, there are no known predictors of diverticulitis or ways to prevent a relapse of diverticulitis.
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There is evidence from a study of a cohort in Boston, in which vitamin D levels were assessed as a possible predictor of diverticulitis in patients with diverticulosis. Patients with low serum hydroxyvitamin D levels had a much higher likelihood of having diverticulitis or complications of diverticulitis. Vitamin D levels were normal in patients with uncomplicated diverticulosis. Why does that make sense?
Vitamin D has a role in maintaining colonic homeostasis and mucosal integrity and in modulating inflammation in the gut. It makes sense that lower vitamin D levels might be associated with a lower incidence of diverticulitis. Diverticulosis and particularly diverticulitis have some seasonal variation, as does inflammatory bowel disease -- and this may also be associated with the seasonal differences in sun exposure, which may influence the vitamin D level.
So myth number 3, that nothing can be done to prevent the development or recurrence of diverticulitis, is not true. Maybe something can be done. Check the patient's vitamin D levels, or as I do in my practice, just tell patients who have had diverticulosis or diverticulitis, "Take a vitamin D supplement, provided that there are no other contraindications. A daily 2000-IU dose of vitamin D may help you for lots of reasons and has lots of good health implications." It's a relatively easy thing to add in. We don't have any longitudinal prevention data, but certainly the retrospective data are at least suggestive.
Myth #3: Diverticulitis Can't Be Predicted
Myth number 3 is that in patients with diverticulosis, there are no known predictors of diverticulitis or ways to prevent a relapse of diverticulitis.
[ CLOSE WINDOW ]
(Enlarge Slide)
There is evidence from a study of a cohort in Boston, in which vitamin D levels were assessed as a possible predictor of diverticulitis in patients with diverticulosis. Patients with low serum hydroxyvitamin D levels had a much higher likelihood of having diverticulitis or complications of diverticulitis. Vitamin D levels were normal in patients with uncomplicated diverticulosis. Why does that make sense?
Vitamin D has a role in maintaining colonic homeostasis and mucosal integrity and in modulating inflammation in the gut. It makes sense that lower vitamin D levels might be associated with a lower incidence of diverticulitis. Diverticulosis and particularly diverticulitis have some seasonal variation, as does inflammatory bowel disease -- and this may also be associated with the seasonal differences in sun exposure, which may influence the vitamin D level.
So myth number 3, that nothing can be done to prevent the development or recurrence of diverticulitis, is not true. Maybe something can be done. Check the patient's vitamin D levels, or as I do in my practice, just tell patients who have had diverticulosis or diverticulitis, "Take a vitamin D supplement, provided that there are no other contraindications. A daily 2000-IU dose of vitamin D may help you for lots of reasons and has lots of good health implications." It's a relatively easy thing to add in. We don't have any longitudinal prevention data, but certainly the retrospective data are at least suggestive.
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