Impact of age on recurrence and severity of left colonic diverticulitis

Lopez-Borao, Jaime; Kreisler, Esther; Millán, Mónica; Trenti, Loris; Jaurrieta, Eduardo; Rodríguez-Moranta, Francisco; Miguel, Bernat; Biondo, Sebastiano

doi:10.1111/j.1463-1318.2012.02976.x

Cited by 39 publications

(42 citation statements)

References 28 publications

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“…Indeed, we found that young patients have an increased risk of recurrence compared with older adults. 4,5,40,48,50,51,53 Again, this…”

Section: Discussionmentioning

confidence: 88%

“…Only three studies assessed re-recurrent disease and were limited to episodes associated with a hospital admission. 5,51,53 We know surprisingly little about this population, the natural history of their illness, and their burden of disease.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,40,48,50,51,53 We estimated that in younger patients (under 45-50 years) the risk of recurrence may be 234 events per 1000 patients followed for 5 years (95% CI from 217 to 256 per 1000; low quality evidence). In patients aged 50 years or older, this risk seems to be lower: 166 per 1000 patients (95% CI from 163 to 174 per 1000; low quality evidence).…”

Section: Outcomes Of Patients Treated Medicallymentioning

confidence: 99%

“…In three studies, the number of recurrences per patient was reported. 5, 53 Among those who will have a recurrence, approximately two thirds will have a single recurrence while a third will have two or more events over the next 2 to 9 years.…”

Section: Outcomes Of Patients Treated Medicallymentioning

confidence: 99%

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American Gastroenterological Association Institute Technical Review on the Management of Acute Diverticulitis

2015

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“…Indeed, we found that young patients have an increased risk of recurrence compared with older adults. 4,5,40,48,50,51,53 Again, this…”

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Outcomes Of Patients Treated Medicallymentioning

confidence: 99%

Section: Outcomes Of Patients Treated Medicallymentioning

confidence: 99%

See 2 more Smart Citations

American Gastroenterological Association Institute Technical Review on the Management of Acute Diverticulitis

2015

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“…No obstante, al año siguiente se publica un estudio en el que analizan 686 pacientes dividiéndolos en 3 grupos según la edad ( < 45 años, entre 45 y 70 años y >70), demostrando que el curso de la diverticulitis no es más agresivo en los pacientes más jóvenes 35 . Así lo confirma también un estudio de Ritz et al 36 .…”

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Tratamiento ambulatorio de la diverticulitis aguda no complicada: impacto sobre los costes sanitarios

et al. 2013

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Sigmoid Diverticulitis

Morris

Regenbogen

Hardiman

et al. 2014

JAMA

164

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IMPORTANCE Diverticulitis is a common disease. Recent changes in understanding its natural history have substantially modified treatment paradigms.OBJECTIVE To review the etiology and natural history of diverticulitis and recent changes in treatment guidelines. EVIDENCE REVIEWWe searched the MEDLINE and Cochrane databases for English-language articles pertaining to diagnosis and management of diverticulitis published between January 1, 2000, and March 31, 2013. Search terms applied to 4 thematic topics: pathophysiology, natural history, medical management, and indications for surgery. We excluded small case series and articles based on data accrued prior to 2000. We hand searched the bibliographies of included studies, yielding a total of 186 articles for full review. We graded the level of evidence and classified recommendations by size of treatment effect, according to the guidelines from the American Heart Association Task Force on Practice Guidelines.FINDINGS Eighty articles met criteria for analysis. The pathophysiology of diverticulitis is associated with altered gut motility, increased luminal pressure, and a disordered colonic microenvironment. Several studies examined histologic commonalities with inflammatory bowel disease and irritable bowel syndrome but were focused on associative rather than causal pathways. The natural history of uncomplicated diverticulitis is often benign. For example, in a cohort study of 2366 of 3165 patients hospitalized for acute diverticulitis and followed up for 8.9 years, only 13.3% of patients had a recurrence and 3.9%, a second recurrence. In contrast to what was previously thought, the risk of septic peritonitis is reduced and not increased with each recurrence. Patient-reported outcomes studies show 20% to 35% of patients managed nonoperatively progress to chronic abdominal pain compared with 5% to 25% of patients treated operatively. Randomized trials and cohort studies have shown that antibiotics and fiber were not as beneficial as previously thought and that mesalamine might be useful. Surgical therapy for chronic disease is not always warranted. CONCLUSIONS AND RELEVANCERecent studies demonstrate a lesser role for aggressive antibiotic or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary.

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Impact of age on recurrence and severity of left colonic diverticulitis

Abstract: AD does not present a more aggressive clinical course in younger patients and it can be safely managed using the same strategy as in middle aged and older patients.

Cited by 39 publications

References 28 publications

American Gastroenterological Association Institute Technical Review on the Management of Acute Diverticulitis

American Gastroenterological Association Institute Technical Review on the Management of Acute Diverticulitis

Tratamiento ambulatorio de la diverticulitis aguda no complicada: impacto sobre los costes sanitarios

Sigmoid Diverticulitis

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