Diverticular disease is influenced by several risk factors, many of which are modifiable:
Dietary factors
- A diet low in fiber and high in meat is associated with an increased risk of diverticular disease
- A Western dietary pattern, characterized by high intake of red meat, refined grains, and high-fat dairy, is associated with an increased risk of diverticulitis
- Conversely, a prudent dietary pattern, high in fruits, vegetables, and whole grains, is associated with a decreased risk of diverticulitis
- Vegetarians have a 31% lower risk of diverticular disease compared with meat eaters
Lifestyle factors
- Obesity is a significant risk factor for diverticulitis and diverticular bleeding. Compared with men with a BMI of less than 21 kg/m², men with a BMI ≥ 30 kg/m² have a relative risk of 1.78 for diverticulitis and 3.19 for diverticular bleeding
- Physical inactivity is also a risk factor for diverticulitis
- Smoking is a risk factor for diverticulitis, and smoking cessation is recommended to potentially reduce the risk of diverticulitis
Genetic factors
- Genetic factors also contribute to the risk of diverticulitis
Other factors
- Abnormal colonic motility and structural changes in the gut that increase with age are implicated in the pathogenesis of diverticular disease
- Patients with diverticular disease who have colorectal histopathology have an increased risk of overall incident cancer
In conclusion, the risk of diverticular disease is multifactorial, involving dietary and lifestyle factors, genetic predisposition, and other physiological changes. Modifying these risk factors, where possible, may help reduce the risk of developing diverticular disease.