Microbiota Composition in Diverticular Disease: Implications for Therapy

Tursi, Antonio; Papa, Valerio; Lopetuso, Loris Riccardo; Settanni, Carlo Romano; Gasbarrini, Antonio; Papa, Alfredo

doi:10.3390/ijms232314799

Cited by 2 publications

(2 citation statements)

References 72 publications

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“…compared with 35 controls without any diverticula 107 . This suggests a potential role of microbiota in the development of symptoms, and the symbiotic and pathognomonic role of the gut microbiome requires further study 108 ( Table 3 lists intrinsic factors related to DD).…”

Section: Geneticsmentioning

confidence: 99%

Genetic, epigenetic and environmental factors in diverticular disease: systematic review

Humphrey,

Sibley,

Walker

et al. 2024

BJS Open

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Background Diverticulosis is a normal anatomical variant of the colon present in more than 70% of the westernized population over the age of 80. Approximately 3% will develop diverticulitis in their lifetime. Many patients present emergently, suffer high morbidity rates and require substantial healthcare resources. Diverticulosis is the most common finding at colonoscopy and has the potential for causing a significant morbidity rate and burden on healthcare. There is a need to better understand the aetiology and pathogenesis of diverticular disease. Research suggests a genetic susceptibility of 40–50% in the formation of diverticular disease. The aim of this review is to present the hypothesized functional effects of the identified gene loci and environmental factors. Methods A systematic literature review was performed using PubMed, MEDLINE and Embase. Medical subject headings terms used were: ‘diverticular disease, diverticulosis, diverticulitis, genomics, genetics and epigenetics’. A review of grey literature identified environmental factors. Results Of 995 articles identified, 59 articles met the inclusion criteria. Age, obesity and smoking are strongly associated environmental risk factors. Intrinsic factors of the colonic wall are associated with the presence of diverticula. Genetic pathways of interest and environmental risk factors were identified. The COLQ, FAM155A, PHGR1, ARHGAP15, S100A10, and TNFSF15 genes are the strongest candidates for further research. Conclusion There is increasing evidence to support the role of genomics in the spectrum of diverticular disease. Genomic, epigenetic and omic research with demographic context will help improve the understanding and management of this complex disease.

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Section: Geneticsmentioning

confidence: 99%

Genetic, epigenetic and environmental factors in diverticular disease: systematic review

Humphrey,

Sibley,

Walker

et al. 2024

BJS Open

View full text Add to dashboard Cite

show abstract

“… 45 Other studies showed that different microbiota compositions were associated with SUDD. 50 Therefore, colonic microbiota has been considered a therapeutic target for probiotics, fibers, and non-absorbable antibiotics.…”

Section: Symptomatic Uncomplicated Diverticular Diseasementioning

confidence: 99%

Symptomatic Uncomplicated Diverticular Disease (SUDD): Practical Guidance and Challenges for Clinical Management

Calini¹,

Aziz²,

Paolini³

et al. 2023

CEG

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Symptomatic Uncomplicated Diverticular Disease (SUDD) is a syndrome within the diverticular disease spectrum, characterized by local abdominal pain with bowel movement changes but without systemic inflammation. This narrative review reports current knowledge, delivers practical guidance, and reveals challenges for the clinical management of SUDD. A broad and common consensus on the definition of SUDD is still needed. However, it is mainly considered a chronic condition that impairs quality of life (QoL) and is characterized by persistent left lower quadrant abdominal pain with bowel movement changes (eg, diarrhea) and low-grade inflammation (eg, elevated calprotectin) but without systemic inflammation. Age, genetic predisposition, obesity, physical inactivity, low-fiber diet, and smoking are considered risk factors. The pathogenesis of SUDD is not entirely clarified. It seems to result from an interaction between fecal microbiota alterations, neuro-immune enteric interactions, and muscular system dysfunction associated with a low-grade and local inflammatory state. At diagnosis, it is essential to assess baseline clinical and Quality of Life (QoL) scores to evaluate treatment efficacy and, ideally, to enroll patients in cohort studies, clinical trials, or registries. SUDD treatments aim to improve symptoms and QoL, prevent recurrence, and avoid disease progression and complications. An overall healthy lifestyle – physical activity and a high-fiber diet, with a focus on whole grains, fruits, and vegetables – is encouraged. Probiotics could effectively reduce symptoms in patients with SUDD, but their utility is missing adequate evidence. Using Rifaximin plus fiber and Mesalazine offers potential in controlling symptoms in patients with SUDD and might prevent acute diverticulitis. Surgery could be considered in patients with medical treatment failure and persistently impaired QoL. Still, studies with well-defined diagnostic criteria for SUDD that evaluate the safety, QoL, effectiveness, and cost-effectiveness of these interventions using standard scores and comparable outcomes are needed.

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Microbiota Composition in Diverticular Disease: Implications for Therapy

Cited by 2 publications

References 72 publications

Genetic, epigenetic and environmental factors in diverticular disease: systematic review

Genetic, epigenetic and environmental factors in diverticular disease: systematic review

Symptomatic Uncomplicated Diverticular Disease (SUDD): Practical Guidance and Challenges for Clinical Management

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