Uno Y, van Velkinburgh JC. Logical hypothesis: Low FODMAP diet to prevent diverticulitis. World J Gastrointest Pharmacol Ther 2016; 7(4): 503-512 [PMID: 27867683 DOI: 10.4292/wjgpt.v7.i4.503]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pharmacol Ther. Nov 6, 2016; 7(4): 503-512 Published online Nov 6, 2016. doi: 10.4292/wjgpt.v7.i4.503
Logical hypothesis: Low FODMAP diet to prevent diverticulitis
Yoshiharu Uno, Jennifer C van Velkinburgh
Yoshiharu Uno, Office Uno Column (Medical Science Publisher), Onoe-Cho, Hyogo 675-0025, Japan
Jennifer C van Velkinburgh, van Velkinburgh Initiative for Collaboratory Biomedical Research, Santa Fe, NM 87501, United States
Author contributions: Uno Y contributed to creation of theory, reference collection, and creation of the table and figures; Uno Y and van Velkinburgh JC contributed equally to the writing of the manuscript.
Conflict-of-interest statement: Uno Y was granted a trademark of low FODMAP diet from the Japan Patent Office. van Velkinburgh JC declares no conflicts of interest in relation to the publication of this review.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yoshiharu Uno, MD, PhD, Office Uno Column (Medical Science Publisher), Onoe-Cho, Yota 419-2, Hyogo 675-0025, Japan. yoshiharu333@hotmail.com
Telephone: +81-79-4394697 Fax: +81-79-4394697
Received: April 27, 2016 Peer-review started: April 28, 2016 First decision: July 4, 2016 Revised: August 4, 2016 Accepted: August 15, 2016 Article in press: August 17, 2016 Published online: November 6, 2016 Processing time: 187 Days and 2 Hours
Abstract
Despite little evidence for the therapeutic benefits of a high-fiber diet for diverticulitis, it is commonly recommended as part of the clinical management. The ongoing uncertainty of the cause(s) of diverticulitis confounds attempts to determine the validity of this therapy. However, the features of a high-fiber diet represent a logical contradiction for colon diverticulitis. Considering that Bernoulli’s principle, by which enlarged diameter of the lumen leads to increased pressure and decreased fluid velocity, might contribute to development of the diverticulum. Thus, theoretically, prevention of high pressure in the colon would be important and adoption of a low FODMAP diet (consisting of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) may help prevent recurrence of diverticulitis.
Core tip: The ongoing uncertainty of the cause(s) of diverticulitis confounds attempts to determine the validity of this therapy; however, the features of a high-fiber diet represent a logical contradiction for colon diverticulitis. Prevention of high pressure in the colon may help to avoid or correct diverticulitis, and this may be achieved by adoption of a low FODMAP diet (restriction of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols).