Diverticular disease of the colon and concomitant abnormalities in patients undergoing endoscopic evaluation of the large bowel

Abstract

OBJECTIVE: To study the prevalence of diverticula and presence of concomitant pathology in consecutive patients undergoing endoscopic examination of the colon. METHODS: A cross-sectional analysis of the endoscopy reports of all patients sent for endoscopic evaluation of the colon in a period of 8.5 years. RESULTS: A total of 9086 endoscopies were performed. Of these 2259 (24.7%) were undertaken for follow-up. Diverticula were seen in 1849 patients (27%) (739 male, 1110 female, mean age 69 year). In 4978 patients (73%)(2162 male, 2816 female, mean age 52 year) no diverticula were seen, of these 2303 (46%) had no abnormalities in their colon. Patients with diverticula were significantly older, 69 vs 46.7 years (P < 0.001). No difference was present in gender. Colorectal cancer and inflammatory bowel disease were significantly more common in patients without diverticula, while polyps were more often seen in patient with diverticula. Patients with diverticula had a significantly lower incidence of colorectal cancer. In addition, the number of cancers located proximal to the splenic flexure was statistically higher in the group of patients presenting with diverticula (P < 0.001). CONCLUSIONS: The overall prevalence of diverticular disease in patients undergoing endoscopy is 27%, and increases with age. Patients with diverticulosis have significantly lower incidence of colorectal cancer and if cancer is detected then it is more common proximal to the splenic flexure.

A cross sectional study of colonic diverticulosis in the London Bangladeshi population

“…More recent population studies have largely drawn inference from incidence of complications. [3][4][5] However, the results we obtained in Caucasians correspond to publications of prevalence from unselected colonoscopic examinations in large cohorts, [19][20][21] as well as several historic barium enema 25,26 and a All Bangladeshi patients under the age of 60 years with recorded colonic diverticulosis had a single caecal diverticulum on colonoscopy. The reduced number of patients aged over 70 years with colonic diverticulosis is explained by the reduced number of colonoscopies performed in patients older than 70 years of age.…”

“…While colonoscopy has not been used historically to determine prevalence of colonic diverticulosis, this is now the main diagnostic modality for organic colonic disease and has been used in some recent studies. [19][20][21] On this basis, we performed a retrospective analysis of systematically-recorded colonoscopic data in an enriched consecutive cohort (aged >40 years) to test the hypothesis that prevalence of colonic diverticulosis was significantly lower in Bangladeshis compared with other ethnic groups. Findings were correlated with the prevalence of other 'Western' diseases in the cohort.…”

Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies

“…A total of 4,241 patients were included in the study [1,996 (47%) male and 2,245 (53%) female], mean age of 59 and range 18-95. Patients with diverticulosis, polyps, and cancer were significant older than those without: mean age 69 vs. 56, 64 vs. 57, 68 vs. 58, respectively, P<0.0001.…”

“…The prevalence of diverticulosis and subsequently diverticulitis is increasing in the last decades [1,2]. Diverticulosis increases with age; it is estimated less than 10% in those under the age of 40 and increases to 65-70% in those above 65 years of age [3][4][5].…”

“…There are studies in patients with diverticulosis that found an increased incidence of polyps [1,15,16] and colorectal carcinoma (CRC), [17,18] a decreased incidence of polyps [19] and colon carcinoma [1,19], or no difference in CRC [20]. In patients with diverticulitis, an increased [21] and decreased risk [19] for CRC was described.…”