The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review

Background. The natural history of colonic diverticulosis is unclear.Methods. Patients with incidental diverticulosis identified in a previous prospective cross-sectional screening colonoscopy study were evaluated retrospectively for clinic or hospital visit(s) for diverticular disease (DD= acute diverticulitis or diverticular bleeding) using review of electronic health records and patient phone interview.Results. 826 patients were included in the screening colonoscopy study. Three were excluded for prior DD. In all, 224 patients (27.2%; mean age 62.3 ± 8.2) had incidental diverticulosis distributed in the left colon (67.4%), right colon (5.8%), or both (22.8%). Up-to-date information was available on 194 patients. Of those, 144 (74.2%) could be reached for detailed interview and constituted the study population. Over a mean follow-up of 7.0 ± 1.7 years, DD developed in 6 out of 144 patients (4.2%) (4 acute cases of diverticulitis, 1 probable case of diverticular bleeding, and 1 acute case of diverticulitis and diverticular bleeding). Two patients were hospitalized, and none required surgery. The time to event was 5.1 ± 1.6 years and the incidence rate was 5.9 per 1000 patient-years. On multivariate analysis, none of the variables collected at baseline colonoscopy including age, gender, obesity, exercise, fiber intake, alcohol use, constipation, or use of NSAIDs were associated with DD.Conclusion. The natural history of incidental diverticulosis on screening colonoscopy was highly favorable in this well-defined prospectively identified cohort. The common scenario of incidental diverticulosis at screening colonoscopy makes this information clinically relevant and valuable to physicians and patients alike.

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Colonic diverticulosis and the metabolic syndrome: an association?

Revista Española de Enfermedades Digestivas ◽

10.17235/reed.2017.5009/2017 ◽

2017 ◽

Vol 109 ◽

Cited By ~ 3

Author(s):

Cristina Teixeira ◽

Daniel Trabulo ◽

Suzane Ribeiro ◽

Cláudio Rodrigues Martins ◽

Ana Luísa Alves ◽

...

Keyword(s):

Metabolic Syndrome ◽

Colonic Diverticulosis ◽

The Metabolic Syndrome

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Obesity and the Risk of Colonic Diverticulosis

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000000999 ◽

2018 ◽

Vol 61 (4) ◽

pp. 476-483 ◽

Cited By ~ 8

Author(s):

Karn Wijarnpreecha ◽

Wasin Ahuja ◽

Supavit Chesdachai ◽

Charat Thongprayoon ◽

Veeravich Jaruvongvanich ◽

...

Keyword(s):

Colonic Diverticulosis

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Prognostic value of the Diverticular Inflammation and Complication Assessment (DICA) classification

European Journal of Public Health ◽

10.1093/eurpub/ckz186.221 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

G Nasi ◽

A M Mastromatteo ◽

G Cambiè ◽

F Di Mario ◽

W Elisei ◽

...

Keyword(s):

Public Health ◽

Diverticular Disease ◽

Severity Score ◽

Prognostic Value ◽

Complicated Diverticulitis ◽

Significant Relation ◽

Colonic Diverticulosis ◽

Time Period ◽

Endoscopic Classification ◽

The Cost

Abstract Colonic Diverticulosis is one of the most common anatomic alterations found in the clinical practice. This condition has 60% incidence in the population over 60 years old. About 20% of patients with this condition will develop Diverticular Disease, and 5% of them will evolve into Diverticulitis. The aim of the study is to analyse the validation of the classification considering the distribution of the severity DICA score between the patients with diagnosis of colonic Diverticulosis. We analysed and classified with DICA 5635 colonoscopies in the period between January 2012 and April 2018 and we obtained the Hospital Discharge Form from all the patients that had been admitted to the hospital in the same time period. The results showed that 69.9% of the patients were assigned to the score DICA1, 21% to DICA2 and 9.1% to DICA3. Ageing increased both the diagnosis of Diverticular Disease and the severity score. The severity was higher in female patients (DICA1=44.6%,DICA2=50.8%,DICA3=57.8%). The occurrence of complications overall was 5.4% and specifically: not complicated Diverticular Disease (DICA1=1%, DICA2=1.8%, DICA3=3.5%); not complicated Diverticulitis (DICA1=2.1%, DICA2=4.7%, DICA3=6.4%); Bleeding in Diverticulitis (DICA1=0.4%, DICA2=1.2%, DICA3=4.5%); Diverticular Perforation (DICA1=0.0%, DICA2=0.1%, DICA3=0.4%). The complications that needed a surgical procedure were for DICA1 about 0.2%, for DICA2 0.8% and for DICA3 2.5%. As well the average of the occupant days in the hospital and the cost, respectively, was for DICA1:8.5 days and 2300 €; for DICA2:9.5 days and 3080 €; for DICA 3:13 days and 4090 €. The majority of the patients with Diverticular Disease belonged to the severity score DICA1 and the patients classified with DICA3 were mainly female and older than 69 years old. The study confirmed the prognostic value of the endoscopic classification DICA since the occurrence of complication resulted in a statistically significant relation with the score DICA3. Key messages DICA classification was able to discriminate, based on endoscopic records, the patients that could develop complications for Diverticular Disease. DICA classification is a valid parameter to predict the outcome of the disease, with great impact on public health improving the effectiveness of treatment.

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Proton Pump Inhibitor Use May Increase the Risk of Diverticulitis but Not It’s Severity among Patients with Colonic Diverticulosis: A Multicenter Study

Journal of Clinical Medicine ◽

10.3390/jcm9092966 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2966

Author(s):

Wisam Sbeit ◽

Tawfik Khoury ◽

Anas Kadah ◽

Waseem Asadi ◽

Amir Shahin ◽

...

Keyword(s):

Proton Pump Inhibitors ◽

Proton Pump ◽

Developed Countries ◽

Control Group ◽

Colonic Diverticulosis ◽

Hinchey Classification ◽

Modifiable Factors ◽

Modifiable Factor ◽

Colonic Diverticular Disease

Colonic diverticular disease, especially diverticulitis constitutes a major cause of hospitalization and an economic burden in developed countries. Proton pump inhibitors (PPIs) are among the commonest drugs used to treat several diseases affecting the upper gastrointestinal tract. A few studies have reported that the use of Proton Pump Inhibitors PPIs caused dysbiosis. In this study, we searched for a relationship between PPI use and the onset and severity of diverticulitis in patients with colonic diverticulosis. In a retrospective study, patients who were hospitalized for documented diverticulitis were enrolled as cases and compared with a control group of patients with uncomplicated diverticulosis. Overall, 613 patients who had a diagnosis of diverticulosis were included in the study, 217 of whom had diverticulitis. After multivariate analysis, the non-modifiable risk factors associated with diverticulitis included: age (p < 0.0001), hypertension (p < 0.0001), chronic renal failure (p = 0.007), diabetes mellitus (p < 0.0001), and left colon location (p = 0.02). However, among the modifiable factors, only PPI use (p < 0.0001) showed a significant association. Advanced disease severity (according to Hinchey classification of diverticulitis stages II–IV) was associated with aspirin use (p = 0.0004) and pan-colonic location (p = 0.02). PPI use was the only modifiable factor significantly associated with diverticulitis, but not with its severity, among patients with diverticulosis. This observation should be confirmed in future multicenter prospective studies.

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