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January 06, 2021
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More frequent bowel movements may be risk factor for diverticulitis

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More frequent bowel movements were associated with increased incidence of diverticulitis, according to study results.

Andrew T. Chan, MD, MPH, from the division of gastroenterology at Massachusetts General Hospital, and colleagues wrote that it has been long believed that constipation and a low-fiber diet were risk factors for diverticulitis. However, that belief has been challenged in recent years.

“The influence of bowel habits on diverticular disease and diverticulitis is poorly understood,” they wrote. “We sought to prospectively examine the association between bowel movement frequency and risk of incident diverticulitis in two large prospective U.S. cohorts.”

Researchers collected medical history, lifestyle factors and diet from the Nurses’ Health Study (NHS) and the Health Professional Follow-up Study (HPFS) and used it to explore the potential associations.

The NHS comprises nearly 1.3 million person-years of follow-up, whereas the HPFS comprises 386,661 person-years of follow-up. Investigators documented 5,214 and 390 incident cases of diverticulitis in the cohorts, respectively.

Chan and colleagues found an inverse association between the frequency of bowel movements and risk for diverticulitis.

In the NHS, compared with women who had once daily bowel movements, women with more than once-daily bowel movements had an HR of 1.3 (95% CI, 1.19-1.42), and women with fewer than one had an HR of 0.89 (95% CI, 0.82-0.95).

In the HPFS, the corresponding values were 1.29 (95% CI, 1.04-1.59) and 0.61 (95% CI, 0.36-1.03), respectively.

Factors including age, BMI, physical activity, laxative use or fiber intake did not change the association between bowel movements and diverticulitis.

“Additional studies are needed to elucidate the potential mechanisms underlying this association,” Chan and colleagues wrote. “Further understanding of these mechanisms could inform new targets for prevention and treatment of diverticulitis.”