scholarly journals Course of the Diverticular Disease: What is changing?

2020 ◽  
Vol 28 ◽  
pp. 11-16
Author(s):  
Tomica MILOSAVLJEVIĈ ◽  
Giovanni Brandimarte ◽  
Neil Stollman ◽  
Giovanni Barbara ◽  
Adi Lahat ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Current Data ◽  
Laboratory Findings ◽  
Bowel Habits ◽  
Critical Issues ◽  
Irritable Bowel ◽  
Uncomplicated Diverticular Disease

In this session several critical issues in diverticular disease were considered, including “It is Symptomatic Diverticular Disease or Irritable Bowel Syndrome?”, “What do determine evolution to diverticulitis, bowel habits alteration or inflammation?”, and “Prevention of acute diverticulitis: Is it at all possible?”. The first talking compared symptoms and laboratory findings between Symptomatic Uncomplicated Diverticular Disease  (SUDD) and Irritable Bowel Syndrome (IBS). Although both disease share some symptoms, and although IBS can occur in patients having diverticulosis,  SUDD and IBS can be differentiate using a combination of symptoms and laboratory tools. The second talking debated what are the most important risk factors for the evolution towards acute diverticulitis. Current data seem to exclude a significant role of bowel habits alteration, while inflammation seems to have a stronger role, especially in causing acute diverticulitis recurrence. The third talking analyzed about the acute diverticulitis prevention. Primary prevention seem to be little better when using mesalazine, while no definite conclusion can be drawn about the use of fiber and rifaximin. About the secondary prevention, no drugs can be currently advised due to lacking of definite results. At the same time, surgery should be advised on case-by-case basis.

scholarly journals Role of Inflammation in the Pathogenesis of Diverticular Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio Tursi ◽  
Walter Elisei
Keyword(s):  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Human Colon ◽  
Recurrent Abdominal Pain ◽  
Preliminary Evidence ◽  
Low Grade ◽  
Symptom Persistence ◽  
Uncomplicated Diverticular Disease ◽  
Low Grade Inflammation

Diverticulosis of the colon is the most common condition in Western societies and it is the most common anatomic alteration of the human colon. Recurrent abdominal pain is experienced by about 20% of patients with diverticulosis, but the pathophysiologic mechanisms of its occurrence are not completely understood. In the last years, several fine papers have showed clearly the role of low-grade inflammation both in the occurrence of symptoms in people having diverticulosis, both in symptom persistence following acute diverticulitis, even if the evidence available is not so strong. We do not know yet what the trigger of this low-grade inflammation occurrence is. However, some preliminary evidence found colonic dysbiosis linked to low-grade inflammation and therefore to symptom occurrence in those patients. The aim of this paper is to summarize current evidences about the role of inflammation in symptom occurrence in symptomatic uncomplicated diverticular disease and in symptom persistence after an episode of acute diverticulitis.

scholarly journals Efficacy of a New Nutraceutical Formulation in Patients with Symptomatic Uncomplicated Diverticular Disease (SUDD): a Prospective Observational Study

2020 ◽  
Vol 28 ◽  
pp. 49-52
Author(s):  
Ferdinando D'Amico ◽  
Giulia Fiorini ◽  
Antonio Tursi ◽  
Ilaria Maria Saracino ◽  
Matteo Pavoni ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Adverse Events ◽  
Observational Study ◽  
Diverticular Disease ◽  
Prospective Observational Study ◽  
Remission Rate ◽  
Acute Diverticulitis ◽  
Symptom Relief ◽  
Bowel Habits ◽  
Uncomplicated Diverticular Disease

Background and Aim: Symptomatic uncomplicated diverticular disease (SUDD) is characterized by abdominal pain, bloating and altered bowel habits (constipation or diarrhea) attributed to diverticula in the absence of macroscopic mucosal alterations. There is no consensus about management of these patients. DIVER-100®, an association of natural active ingredients may be effective in the treatment of patients with SUDD. The aim was to evaluate the efficacy and safety of DIVER-100® in patients with SUDD. Methods: We conducted a prospective observational study to evaluate the efficacy of DIVER-100® in consecutive patients with SUDD, confirmed by radiology or endoscopy. All patients were treated with DIVER-100® 2 capsules/day 10 days per month, for 3 months. The primary endpoint was the clinical remission rate, defined as the reduction of abdominal pain and bloating, improvement of bowel habits and prevention of acute diverticulitis (AD). The secondary endpoint was the rate of adverse events. Results: One hundred and one patients were consecutively enrolled at the Internal Medicine and Gastroenterology Unit, Sant’Orsola Hospital, Bologna, Italy. DIVER-100® was effective in inducing remission of symptoms in 12 patients (11.9%) at 3 months and in 10 patients (9.9%) at 6 months. DIVER-100® significantly reduced abdominal pain and bloating in 45.5% and 57.4% of patients respectively (p <0.001) after 3 months. No episodes of AD and no adverse events related to DIVER--100® were recorded at month 6 in the study population. Conclusions: DIVER-100® is a safe and effective nutraceutical compound in obtaining remission and symptom relief in SUDD patients. Further randomized, placebo-controlled clinical trials are needed to confirm these preliminary data.

scholarly journals Pathogenesis of Diverticulosis and Diverticular Disease

2020 ◽  
Vol 28 ◽  
pp. 7-10 ◽  
Author(s):  
Juozas Kupcinskas ◽  
Lisa L. Strate ◽  
Gabrio Bassotti ◽  
Gabriele Torti ◽  
László HERSZÈNYI ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Neuromuscular Function ◽  
Fiber Diet ◽  
Genetic Pattern ◽  
Neuromuscular Abnormalities ◽  
Uncomplicated Diverticular Disease

In this session different problems regarding the pathogenesis of diverticular disease were considered, including “Genetics”, “Neuromuscular function abnormalities”, “Patterns of mucosa inflammation”, and “Impact of lifestyle”. The patients affected by diverticular disease have clear genetic pattern, that might predispose to the occurrence of the disease as well as to its complications. Neuromuscular abnormalities may be recognized already at the stage of diverticulosis, and inflammation may explain symptoms occurrence in symptomatic uncomplicated diverticular disease (SUDD) or symptoms persistence after an episode of acute diverticulitis. Finally, lifestyle might also have an impact on symptoms’ occurrence. Specifically smoking, but also obesity seem to play an important role, while the role of low-fiber diet and constipation is now under debate.

The role of intestinal microbiota in the development of urolithiasis in patients with an irritable bowel syndrome

2020 ◽  
Vol 0 (3) ◽  
pp. 29-36
Author(s):  
I. A. Derkach ◽  
A. E. Dorofeyev ◽  
M. M. Rudenko ◽  
G. A. Dorofeyeva ◽  
Yu. Z. Dynia
Keyword(s):  
Irritable Bowel Syndrome ◽  
Intestinal Microbiota ◽  
Irritable Bowel

Review: The Role of MOP and DOP Receptors in Treatment of Diarrheapredominant Irritable Bowel Syndrome

2016 ◽  
Vol 16 (18) ◽  
pp. 1462-1469 ◽  
Author(s):  
Agata Jarmu| ◽  
Marta Zieli|ska ◽  
Karolina Le| ◽  
Martyna Banaszek ◽  
Martin Storr ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Irritable Bowel

scholarly journals Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1288
Author(s):  
Marilia Carabotti ◽  
Francesca Falangone ◽  
Rosario Cuomo ◽  
Bruno Annibale
Keyword(s):  
Systematic Review ◽  
Diverticular Disease ◽  
Dietary Habits ◽  
Acute Diverticulitis ◽  
High Quality ◽  
Eligibility Criteria ◽  
Diverticular Bleeding ◽  
Recurrent Diverticulitis ◽  
Increased Risk

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients with diverticula disease. PubMed and Scopus databases were searched up to 19 January 2021, 330 records were identified, and 8 articles met the eligibility criteria and were subjected to data extraction. The quality of the studies was evaluated by the Newcastle-Ottawa quality assessment form. No study meets the criteria for being a high-quality study. A high intake of fiber was associated to a decreased risk of diverticulitis or hospitalization due to diverticular disease, with a protective effect for fruits and cereal fiber, but not for vegetable fiber; whereas, a high red meat consumption and a generally Western dietary pattern were associated with an increased risk of diverticulitis. Alcohol use seemed to be associated to diverticular bleeding, but not to recurrent diverticulitis or diverticular complications. Further high-quality studies are needed to better define these associations. It is mandatory to ascertain the role of dietary habits for the development of recurrent acute diverticulitis and diverticular bleeding.

scholarly journals Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance

2021 ◽  
Vol 11 (4) ◽  
pp. 298
Author(s):  
Andrea Piccioni ◽  
Laura Franza ◽  
Mattia Brigida ◽  
Christian Zanza ◽  
Enrico Torelli ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Bacterial Species ◽  
Mucosal Inflammation ◽  
Abdominal Symptoms ◽  
Pubmed Database ◽  
Anti Inflammatory ◽  
Key Terms

How can the knowledge of probiotics and their mechanisms of action be translated into clinical practice when treating patients with diverticular disease and acute diverticulitis? Changes in microbiota composition have been observed in patients who were developing acute diverticulitis, with a reduction of taxa with anti-inflammatory activity, such as Clostridium cluster IV, Lactobacilli and Bacteroides. Recent observations supported that a dysbiosis characterised by decreased presence of anti-inflammatory bacterial species might be linked to mucosal inflammation, and a vicious cycle results from a mucosal inflammation driving dysbiosis at the same time. An alteration in gut microbiota can lead to an altered activation of nerve fibres, and subsequent neuronal and muscular dysfunction, thus favoring abdominal symptoms’ development. The possible role of dysbiosis and mucosal inflammation in leading to dysmotility is linked, in turn, to bacterial translocation from the lumen of the diverticulum to perivisceral area. There, a possible activation of Toll-like receptors has been described, with a subsequent inflammatory reaction at the level of the perivisceral tissues. Being aware that bacterial colonisation of diverticula is involved in the pathogenesis of acute diverticulitis, the rationale for the potential role of probiotics in the treatment of this disease becomes clearer. For this review, articles were identified using the electronic PubMed database through a comprehensive search conducted by combining key terms such as “gut microbiota”, “probiotics and gut disease”, “probiotics and acute diverticulitis”, “probiotics and diverticular disease”, “probiotics mechanism of action”. However, the amount of data present on this matter is not sufficient to draw robust conclusions on the efficacy of probiotics for symptoms’ management in diverticular disease.

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