Diverticulosis and Diverticulitis

2015 ◽  
Author(s):  
Anna M. Duloy ◽  
Frederick L Makrauer
Keyword(s):  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
The Elderly ◽  
Acute Illness ◽  
Mucosal Inflammation ◽  
Computed Tomography Scan ◽  
Management Algorithm ◽  
Hinchey Classification ◽  
Uncomplicated Diverticular Disease ◽  
Tomography Scan

Diverticular disease has been considered a disease of the elderly, but recently, an increased incidence has been noted in younger patients. Diverticulosis is asymptomatic; however, when symptomatic, it is referred to as diverticular disease. When associated with any inflammation, it is diverticulitis. Diverticulitis is an acute illness, but symptoms may become chronic with recurrent episodes. When mucosal inflammation is present, segmental colitis associated with diverticula (SCAD) is identified. SCAD is a distinct, but uncommon, disorder sharing histological and clinical features of ulcerative colitis and Crohn disease. Only 1 to 2% of patients with diverticulosis will develop diverticulitis. This review covers the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, management, complications and prognosis of diverticulosis, and diverticulitis. Figures show diverticulosis, symptomatic uncomplicated diverticular disease, diverticulitis, computed tomography scan of acute diverticulitis, and a management algorithm. Tables list definitions, risk factors, pathophysiology, modified Hinchey classification, and acute diverticulitis differential diagnosis.   This review contains 5 highly rendered figures, 5 tables and 105 references

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.

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 Computed tomography scan in the evaluation of patients with stroke

2012 ◽  
Vol 8 (2) ◽  
pp. 24-31
Author(s):  
PK Chhetri ◽  
S Raut
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Eating Habits ◽  
Cavernous Angioma ◽  
The Elderly ◽  
Cerebrovascular Diseases ◽  
Computed Tomography Scan ◽  
Stroke Risk Factors ◽  
Neurology Clinic ◽  
Tomography Scan

Cerebrovascular accident is a frequent cause of death and disability in most parts of the globe. The incidence of cerebrovascular diseases increases with age and the number of strokes is projected to increase as the elderly population grows. This study was undertaken to determine the type of stroke and also to relate the risks factors associated with stroke. Hundred consecutive patients presenting with stroke in the emergency department / neurology clinic were subjected to computed tomography scan of the brain. Sixty – four patients had ischemic infarct and 36 had intracranial hemorrhage which included 2 patients with subarachnoid hemorrhage and 1 with underlying cavernous angioma. Ischemic stroke was thus commoner than hemorrhagic stroke. Previous infarct or lacunes were noted in 25 % of the patients presenting with stroke. Risk factors were present in most (77 %) of the patients presenting with stroke. Among the various risk factors, the single most common was smoking seen in 38 cases, followed by hypertension in 28 cases, obesity in 8 cases and diabetes in 3 cases. Twenty- one patients had multiple combinations of the above risk factors. Among the multiple risk factors, combination of alcohol and smoking was the commonest seen in 11 cases, followed by hypertension and obesity in 8 cases and alcohol with obesity in 2 cases. Change in lifestyle and eating habits may thus help reduce the incidence of stroke. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 24-31 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6834

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 Appendiceal diverticulitis presenting as acute appendicitis diagnosed postoperatively

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Majid Z Albeeshi ◽  
Abdullah A Alwanyan ◽  
Alaa A Salim ◽  
Ibrahim T Albabtain
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diverticular Disease ◽  
Laparoscopic Appendectomy ◽  
Rare Entity ◽  
Computed Tomography Scan ◽  
History Of ◽  
Appendiceal Diverticulitis ◽  
Tomography Scan

Abstract Appendiceal diverticular disease is a rare entity. We report a case of appendiceal diverticulitis mimicking acute appendicitis and diagnosed postoperatively on histopathology. A 28-year-old female presented with a 2-day history of shifting periumbilical pain associated with nausea and anorexia. A computed tomography scan of the abdomen demonstrated acute appendicitis. She was taken to laparoscopic appendectomy. Histopathology showed appendiceal diverticulitis, and perforation of an inflamed diverticulum with periappendicitis. Diverticulosis of the appendix is classified as congenital and acquired. Diagnosis can be made preoperatively by imaging. In this case, diverticulosis was not radiologically evident, and was interpreted as acute appendicitis. Gross appearance of the resected appendix was not suggestive of diverticulitis. Other cases reported that the gross specimen had evidence of diverticular disease. Surgeons should be aware that inflamed appendixes may harbor different pathologies warranting further management.

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 Mesalazine for People with Diverticular Disease: A Systematic Review of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Andrea Iannone ◽  
Marinella Ruospo ◽  
Germaine Wong ◽  
Michele Barone ◽  
Mariabeatrice Principi ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Disease Recurrence ◽  
Current Evidence ◽  
Random Effects Models ◽  
Disease Remission ◽  
Uncomplicated Diverticulitis ◽  
Disease Subtype ◽  
Uncomplicated Diverticular Disease ◽  
Acute Uncomplicated Diverticulitis

Background. Diverticular disease treatment is limited to fibres, antibiotics, and surgery. There is conflicting evidence on mesalazine benefits and harms. Aim. We systematically reviewed current evidence on benefits and harms of mesalazine versus all other treatments in people with diverticular disease. Methods. We searched MEDLINE, EMBASE, CENTRAL, ClinicalTrials.gov for studies published to July 2018. We estimated risk ratios (RR) for dichotomous outcomes (disease remission/recurrence, acute diverticulitis in symptomatic uncomplicated diverticular disease, need for surgery/hospitalization, all-cause/disease-related mortality, adverse events), mean differences (MD) or standardized MD (SMD) for continuous outcomes (quality of life, symptoms score, time to recurrence/remission), and their 95% confidence intervals (CI) using random-effects models. We quantified heterogeneity by Chi2 and I2 tests. We performed subgroup analyses by disease subtype, comparator, follow-up duration, mesalazine dose, and mode of administration. Results. We identified 13 randomized trials (n=3028 participants). There was a higher likelihood of disease remission with mesalazine than controls in acute uncomplicated diverticulitis (1 trial, 81 participants, RR=2.67, 95%CI=1.05-6.79), but not in symptomatic uncomplicated diverticular disease (1 trial, 123 participants, RR=1.04, 95%CI=0.81-1.34). There was a lower likelihood of disease recurrence with mesalazine than controls in symptomatic uncomplicated diverticular disease (2 trials, 216 participants, RR=0.52, 95%CI=0.28-0.97), but not in acute uncomplicated diverticulitis (7 trials, 2196 participants, RR=0.90, 95%CI=0.61-1.33). There was no difference in the likelihood of developing acute diverticulitis in symptomatic uncomplicated diverticular disease between the two groups (3 trials, 484 participants, RR=0.26, 95%CI=0.06-1.20). There was a higher global symptoms score reduction with mesalazine than controls in symptomatic uncomplicated diverticular disease (2 trials, 326 participants, SMD=-1.01, 95%CI=-1.51,-0.52) and acute uncomplicated diverticulitis (2 trials, 153 participants, SMD=-0.56, 95%CI=-0.88,-0.24). Conclusions. Mesalazine may reduce recurrences in symptomatic uncomplicated diverticular disease. There is uncertainty on the effect of mesalazine in achieving diverticular disease remission. Mesalazine may not prevent acute diverticulitis in symptomatic uncomplicated diverticular disease.

Absence of Mucosal Inflammation in Uncomplicated Diverticular Disease

2011 ◽  
Vol 56 (7) ◽  
pp. 2098-2103 ◽  
Author(s):  
Luca Elli ◽  
Leda Roncoroni ◽  
Maria Teresa Bardella ◽  
Claudia Terrani ◽  
Antonella Bonura ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Mucosal Inflammation ◽  
Uncomplicated Diverticular Disease

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.

Sign in / Sign up

Export Citation Format

Share Document