No established guidelines are available for secondary prevention of diverticulitis. However, promoting general health measures such as regular physical activity, increasing consumption of fruits and vegetables, and decreasing consumption of saturated fats, red meats, and sugar will improve cardiovascular health and may decrease prevalence of diverticulitis.[43]Peery AF, Shaukat A, Strate LL. AGA clinical practice update on medical management of colonic diverticulitis: expert review. Gastroenterology. 2021 Feb;160(3):906-11.e1.
https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2820%2935512-8
http://www.ncbi.nlm.nih.gov/pubmed/33279517?tool=bestpractice.com
[60]Eberhardt F, Crichton M, Dahl C, et al. Role of dietary fibre in older adults with asymptomatic (AS) or symptomatic uncomplicated diverticular disease (SUDD): systematic review and meta-analysis. Maturitas. 2019 Dec;130:57-67.
http://www.ncbi.nlm.nih.gov/pubmed/31706437?tool=bestpractice.com
[108]Aldoori WH, Giovannucci EL, Rimm EB, et al. Prospective study of physical activity and risk of symptomatic diverticular disease in men. Gut. 1995 Feb;36(2):276-82.
http://www.ncbi.nlm.nih.gov/pubmed/7883230?tool=bestpractice.com
Mesalamine, probiotics, or rifaximin are not recommended for the prevention of recurrent diverticulitis.[43]Peery AF, Shaukat A, Strate LL. AGA clinical practice update on medical management of colonic diverticulitis: expert review. Gastroenterology. 2021 Feb;160(3):906-11.e1.
https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2820%2935512-8
http://www.ncbi.nlm.nih.gov/pubmed/33279517?tool=bestpractice.com
[59]Qaseem A, Etxeandia-Ikobaltzeta I, Lin JS, et al; Clinical Guidelines Committee of the American College of Physicians. Colonoscopy for diagnostic evaluation and interventions to prevent recurrence after acute left-sided colonic diverticulitis: a clinical guideline from the American College of Physicians. Ann Intern Med. 2022 Mar;175(3):416-31.
https://www.acpjournals.org/doi/10.7326/M21-2711
http://www.ncbi.nlm.nih.gov/pubmed/35038270?tool=bestpractice.com
Evidence shows that mesalamine does not reduce the risk of recurrence.[101]Balk EM, Adam GP, Cao W, et al. Evaluation and management after acute left-sided colonic diverticulitis : a systematic review. Ann Intern Med. 2022 Mar;175(3):388-98.
https://www.acpjournals.org/doi/10.7326/M21-1646
http://www.ncbi.nlm.nih.gov/pubmed/35038269?tool=bestpractice.com
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For people with diverticulitis, how does mesalamine (5-ASA) compare with placebo for prevention of recurrence?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.1968/fullShow me the answer There is insufficient evidence for the use of rifaximin, mesalamine and rifaximin in combination, balsalazide (a 5-aminosalicylic acid prodrug) and probiotics in combination, or burdock tea.[59]Qaseem A, Etxeandia-Ikobaltzeta I, Lin JS, et al; Clinical Guidelines Committee of the American College of Physicians. Colonoscopy for diagnostic evaluation and interventions to prevent recurrence after acute left-sided colonic diverticulitis: a clinical guideline from the American College of Physicians. Ann Intern Med. 2022 Mar;175(3):416-31.
https://www.acpjournals.org/doi/10.7326/M21-2711
http://www.ncbi.nlm.nih.gov/pubmed/35038270?tool=bestpractice.com
[101]Balk EM, Adam GP, Cao W, et al. Evaluation and management after acute left-sided colonic diverticulitis : a systematic review. Ann Intern Med. 2022 Mar;175(3):388-98.
https://www.acpjournals.org/doi/10.7326/M21-1646
http://www.ncbi.nlm.nih.gov/pubmed/35038269?tool=bestpractice.com