Clinically Diagnosed Acute Diverticulitis in Outpatients: Misdiagnosis in Patients with Irritable Bowel Syndrome

Longstreth, George F.; Tieu, Ryan

doi:10.1007/s10620-015-3892-5

Cited by 10 publications

(5 citation statements)

References 48 publications

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“…While complications and surgery related to diverticulitis were confirmed by physician review for all patients, abdominal pain related to irritable bowel syndrome may be misattributed to diverticulitis. 9 The BMI was not available for 7% of patients with diverticulitis. Between 1980 and 2007, only 1.6% of Olmsted County residents had a BMI < 18.5 kg/m 2 , limiting our ability to analyze this group separately.…”

Section: Discussionmentioning

confidence: 99%

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Aging, Obesity, and the Incidence of Diverticulitis: A Population-Based Study

Lee

Setty

Parthasarathy

et al. 2018

Mayo Clinic Proceedings

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Aging, increasing obesity, and the increased incidence of diverticulitis in people with normal BMI account for the temporal increase in diverticulitis. Rather than BMI per se, increased abdominal visceral and subcutaneous fat are independently associated with diverticulitis. The incidence of diverticulitis, which is among the most common gastrointestinal diagnoses in hospitalized patients, has increased markedly since 2000. This study suggests that aging, increasing obesity, and the increased incidence of diverticulitis in people with normal BMI account for the temporal increase in diverticulitis.

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Section: Discussionmentioning

confidence: 99%

“…8 Since abdominal pain related to irritable bowel syndrome may be misattributed to diverticulitis, a clinical assessment may increase the specificity of a diagnosis of diverticulitis. 9 Inpatient series exclude most patients with uncomplicated disease, who are treated as outpatients. 10 Self-reported BMI may not be accurate.…”

Section: Introductionmentioning

confidence: 99%

Aging, Obesity, and the Incidence of Diverticulitis: A Population-Based Study

Lee

Setty

Parthasarathy

et al. 2018

Mayo Clinic Proceedings

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“…28 Also, irritable bowel syndrome can be misdiagnosed to be diverticulitis in up to 9% of patients, even after imaging. 48 These patients can continue to have symptoms even after sigmoid resection. 48,49…”

Section: Recurrence Of Diverticulitis After Sigmoid Resectionmentioning

confidence: 99%

Surgical Management of Recurrent Uncomplicated Diverticulitis

Rai

Mishra

2020

Clin Colon Rectal Surg

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Sigmoid diverticulitis represents a most common gastroenterological diagnosis in the western world. There has been a significant change in the management of recurrent uncomplicated diverticulitis in the last 10 to 15 years. The absolute number of previous episodes is not used as criteria to recommend surgery anymore. Young age is no longer considered to be an indication for more aggressive surgical treatment. It is accepted that subsequent episodes of diverticulitis are not significantly worse than the first episode. Laparoscopic surgery is now the standard of care for elective surgery for diverticulitis where expertise is available. There is a consensus that decision to perform sigmoid colectomy should be individualized, after careful risk benefit assessment.

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“…Symptoms consistent with IBS are common among patients with DD, and this symptomology has been reported as significantly higher in the DD patients when compared to non-DD controls[103-105]. However, this overlap of symptoms can cause diverticulitis to be misdiagnosed as IBS[104]. …”

Section: Alternative Diet For Diverticulitismentioning

confidence: 99%

Logical hypothesis: Low FODMAP diet to prevent diverticulitis

Uno¹,

Velkinburgh²

2016

WJGPT

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Despite little evidence for the therapeutic benefits of a high-fiber diet for diverticulitis, it is commonly recommended as part of the clinical management. The ongoing uncertainty of the cause(s) of diverticulitis confounds attempts to determine the validity of this therapy. However, the features of a high-fiber diet represent a logical contradiction for colon diverticulitis. Considering that Bernoulli’s principle, by which enlarged diameter of the lumen leads to increased pressure and decreased fluid velocity, might contribute to development of the diverticulum. Thus, theoretically, prevention of high pressure in the colon would be important and adoption of a low FODMAP diet (consisting of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) may help prevent recurrence of diverticulitis.

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Clinically Diagnosed Acute Diverticulitis in Outpatients: Misdiagnosis in Patients with Irritable Bowel Syndrome

Abstract: Multiple types of indirect and concordant evidence suggest misattribution of IBS pain to diverticulitis and unnecessary antibiotic therapy in outpatients.

Cited by 10 publications

References 48 publications

Aging, Obesity, and the Incidence of Diverticulitis: A Population-Based Study

Aging, Obesity, and the Incidence of Diverticulitis: A Population-Based Study

Surgical Management of Recurrent Uncomplicated Diverticulitis

Logical hypothesis: Low FODMAP diet to prevent diverticulitis

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