Distribution and Characteristics of Colonic Diverticula in a United States Screening Population

Peery, Anne F.; Keku, Tope O.; Martin, Christopher F.; Eluri, Swathi; Runge, Thomas M.; Galanko, Joseph A.; Sandler, Robert S.

doi:10.1016/j.cgh.2016.01.020

Cited by 146 publications

(143 citation statements)

References 26 publications

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“…The detection rate of multiple diverticula increased with age, which was particularly prominent in people aged > 65 years, and the rate of increase in multiple diverticula was 3-times higher than that of single diverticulum. Similar findings have been reported in the literature [22], but the underlying reason is unclear. We suspect that this may be the result of a combination of factors.…”

Section: Discussionsupporting

confidence: 81%

Gender, Age, and Concomitant Diseases of Colorectal Diverticulum in China: A Study of 7,964 Cases

Wang

Dai

et al. 2018

Dig Dis

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Aim: To analyze the epidemiological features of colorectal diverticulum (CRD) in China. Methods: We retrospectively analyzed CRD patients in 8 tertiary hospitals located in 5 regions of China from 2000 to 2016. The detection rates, number and distribution, demographic information, concomitant disorders, and their associations were investigated. Results: Of 3,446,118 cases, 7,964 (2.3%) were CRD with a mean age of 56 years (11–92 years). The detection rate increased yearly and with increasing age. Males had a higher detection rate than females (3.0 vs. 1.47%, p < 0.01) and 1.8-times higher increase rate. The detection rate increased with age; however, females of > 60 years had a 2.8-times increasing rate than males. CRD occurred most frequently in the right-side colon, followed by rectum. Multiple diverticula were common in males and increased with age, with a 3-times higher increase rate than single lesion. Single-segment CRD occurred more frequently in males than in females (80.1 vs. 76.4%, p < 0.01). Concurred colon polyps were seen in 51.05% cases. Conclusion: CRD detection rates increased annually and with age, particularly in senior females in China. Multiple diverticula were common in males and increased with age. CRD was predominant in the right-side colon. Polyps are the most common comorbidity associated with CRD.

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Section: Discussionsupporting

confidence: 81%

Gender, Age, and Concomitant Diseases of Colorectal Diverticulum in China: A Study of 7,964 Cases

Wang

Dai

et al. 2018

Dig Dis

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“…Participants with diverticula were more likely to be older and male; moreover, they had a higher body mass index and waist circumference than those without diverticula. The prevalence of diverticulosis was 35% in those younger than 50 years, 40% in individuals 50-59 years old, and 58% in those older than 60 years [9]. The prevalence of diverticulosis according to the Clinical Outcomes Research Initiative National Endoscopy Database was 33% in individuals 50-59 years old and 71% in those older than 80 years [10].…”

Section: Diverticulosismentioning

confidence: 89%

“…Diverticula were located only in the sigmoid colon in 65% of patients and in other parts of the colon, along with the sigmoid colon, in 24% of patients; they were equally distributed throughout the colon in 7% of patients and were located in a segment proximal to the sigmoid colon in 4% of patients. In one prospective study of 624 individuals undergoing screening colonoscopy in the United States, 260 (42%) had colonic diverticulosis [9]. Participants with diverticula were more likely to be older and male; moreover, they had a higher body mass index and waist circumference than those without diverticula.…”

Section: Diverticulosismentioning

confidence: 99%

The Burden of Diverticular Disease and Its Complications: West versus East

Imaeda¹,

Hibi²

2018

Inflamm Intest Dis

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Background: Colonic diverticulosis is prevalent and increasing not only in Western but also in Asian countries. Diverticulosis can be complicated by diverticulitis and diverticular bleeding. Diverticular disease is a burdensome digestive disease, because it is a major cause of hospital admissions and is associated with significant health-care costs. Summary: The incidence of diverticulosis increases with age. Most cases of diverticulosis in Western countries involve the left side of the colon, while diverticulosis is predominantly present on the right side of the colon in Asian countries. The incidence of diverticulitis also increases with age. Diverticulitis is predominantly located on the left side of the colon in Western countries, while it is predominantly located on the right side of the colon in Asian countries. The overall complication rate is higher in left-sided than in right-sided diverticulitis. The incidence of diverticular bleeding also increases with age. The right colon is the source of diverticular bleeding in more than 50% of patients in Western countries. In Asian countries, age greater than 70 years and both-sided diverticulosis increase the bleeding risk. Key Messages: In Western countries, diverticulosis and diverticulitis are predominantly located on the left side of the colon, whereas they are predominantly present on the right side of the colon in Asian countries. Diverticular bleeding is predominantly located on the right side in Western countries, and both-sided diverticulosis increases the risk of bleeding in Asian countries. Diverticular disease with complications requires admission and operation; moreover, it recurs frequently. Therefore, diverticular disease is associated with a significant economic burden in terms of health-care costs and resource utilization.

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“…In an American study, 28% of individuals with a mean age of 55 years had ≥3 diverticula, 32% had 1-2, and 40% had 0, for an overall prevalence of 60% [25]. Another study of individuals with a mean age of 55 years showed the prevalence of diverticula was 42% [26]. According to statistics published during 2001-2010 in Japan, the prevalence of colonic diverticula in individuals with a mean age of 52 years was 23.9% [2].…”

Section: Epidemiology Of Diverticula In the Colonmentioning

confidence: 99%

“…In the United States, 80% of colonic diverticula occur on the left side including 70% occurring in the sigmoid colon, which account for the majority of colonic diverticula. However, incidence varies by race in the United States, and Caucasian populations have a high incidence of diverticula in the sigmoid colon [26], suggesting that the anatomical side of colonic diverticula varies with race.…”

Section: Cq2: Does the Frequency Of Colonic Diverticula Vary By Sitementioning

confidence: 99%

Guidelines for Colonic Diverticular Bleeding and Colonic Diverticulitis: Japan Gastroenterological Association

et al. 2019

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Colonic diverticular disease has been increasing in prevalence in Japan due to the rapidly aging population. Colonic diverticular bleeding can result in hemorrhagic shock requiring blood transfusion, and it carries a high risk of recurrence within 1 year. Colonic diverticulitis can cause abscess, fistula formation, and perforation of the colon that may require surgery, and it often recurs. As a result, patients with colonic diverticular disease are often bothered by required frequent examinations, re-hospitalization, and a consequent decrease in quality of life. However, the management of diverticular disease differs between Japan and Western countries. For example, computed tomography (CT) is readily accessible at Japanese hospitals, so urgent CT may be selected as the first diagnostic procedure for suspected diverticular disease. Endoscopic clipping or band ligation may be preferred as the first endoscopic procedure for diverticular bleeding. Administration of antibiotics and complete bowel rest may be considered as first-line therapy for colonic diverticulitis. In addition, diverticula occur mainly in the sigmoid colon in Western countries, whereas the right side or bilateral of the colon is more commonly involved in Japan. As such, diverticular disease in the right-side colon is more prevalent in Japan than in Western countries. Against this background, concern is growing about the management of colonic diverticular disease in Japan and there is currently no practice guideline available. To address this situation, the Japanese Gastroenterological Association decided to create a clinical guideline for colonic diverticular bleeding and colonic diverticulitis in collaboration with the Japanese Society of Gastroenterology, Japan Gastroenterological Endoscopy Society, and Japanese Society of Interventional Radiology. The steps taken to establish this guideline involved incorporating the concept of the GRADE system for rating clinical guidelines, developing clinical questions (CQs), accumulating evidence through a literature search and review, and developing the Statement and Explanation sections. This guideline includes 2CQs for colonic diverticulosis, 24 CQs for colonic diverticular bleeding, and 17 CQs for diverticulitis.

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Distribution and Characteristics of Colonic Diverticula in a United States Screening Population

Cited by 146 publications

References 26 publications

Gender, Age, and Concomitant Diseases of Colorectal Diverticulum in China: A Study of 7,964 Cases

Gender, Age, and Concomitant Diseases of Colorectal Diverticulum in China: A Study of 7,964 Cases

The Burden of Diverticular Disease and Its Complications: West versus East

Guidelines for Colonic Diverticular Bleeding and Colonic Diverticulitis: Japan Gastroenterological Association

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