Obesity Increases the Risks of Diverticulitis and Diverticular Bleeding

Strate, Lisa L.; Liu, Yan L.; Aldoori, Walid; Syngal, Sapna; Giovannucci, Edward

doi:10.1053/j.gastro.2008.09.025

Cited by 358 publications

(277 citation statements)

References 52 publications

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“…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.…”

Section: Discussionsupporting

confidence: 85%

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

et al. 2013

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Background: Diverticular disease is the most common morphological abnormality of the colon and the fifth most important gastrointestinal disease in terms of cost in the Western world. Tower Hamlets is the poorest borough in London containing a large Bangladeshi community. We observed that emergency admissions with complications of colonic diverticulosis were minimal in the Bangladeshi community. The objective was to compare the background prevalence of colonic diverticulosis in Bangladeshis with other ethnicities in patients undergoing colonoscopy at a single centre in Tower Hamlets. Methods: Four thousand four hundred and fifty-four consecutive colonoscopy reports over a 2-year period were retrospectively analysed. Patients under 40 years of age and repeat colonoscopies were excluded, leaving 3151 patients (mean age: 63 years; 48% male). Demographics including ethnicity and medical background were retrieved from the electronic patient record system and findings correlated with the prevalence of other 'Western' diseases in the cohort. Results: Six hundred and thirty out of 3151 (20%) colonoscopies were performed on Bangladeshis. The prevalence of colonic diverticulosis was significantly lower in Bangladeshis (17/630: 2.7%) than Caucasians (673/1869: 36%), Indians/Pakistanis (16/161: 9.9%), Oriental (15/44: 34%) and Black (90/369: 24.4%) patient groups ( 2 p < 0.0001 for all comparisons). The prevalence of classical sigmoid diverticulosis in the Bangladeshi cohort was only 1.0%, despite significantly more Bangladeshi patients undergoing colonoscopy for abdominal pain (p < 0.0001, 2 ) and diarrhoea (p < 0.0034, 2 ). There was also a significantly greater incidence of type 2 diabetes mellitus and ischaemic heart disease (p < 0.0001, 2 ) in Bangladeshi patients. Conclusions: There is a negligible prevalence of colonic diverticulosis in the Bangladeshi population of London who undergo colonoscopy. This is in spite of a high incidence of type 2 diabetes and ischaemic heart disease. The effect of diet and genetics on the prevalence of colonic diverticulosis in Bangladeshis is not known and merits further investigation.

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Section: Discussionsupporting

confidence: 85%

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

et al. 2013

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“…Finally, obesity has also been associated with many other non-CVD-related health complications, including osteoarthritis, obstructive sleep apnea, polycystic ovarian syndrome, depression, gastrointestinal diseases, and cancer, to name a few. [27][28][29][30][31][32][33][34][35][36][37][38] Comorbidities of Obesity in Children and Adolescents Obesity in childhood and adolescence is associated with a variety of concurrent metabolic and CVD risk factor derangements such as insulin resistance and T2DM, systemic hypertension, dyslipidemia, and inflammation. Worldwide, T2DM has increased in adolescents in the past few decades in parallel with the obesity pandemic, 39 suggesting an impending earlier onset of diabetic vascular complications.…”

Section: Comorbidities Of Obesity In Adultsmentioning

confidence: 99%

Prevention of Overweight/Obesity as a Strategy to Optimize Cardiovascular Health

et al. 2011

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he prevalence of obesity in the United States and the world has risen to epidemic/pandemic proportions. This increase has occurred despite efforts by healthcare providers and consumers alike to improve the health-related behaviors of the population and a tremendous push from the scientific community to better understand the pathophysiology of obesity. This epidemic is all the more concerning given the clear association between excess adiposity and adverse health consequences such as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). These risks associated with overweight/obesity are primarily related to the deposition of excess adiposity or body fatness. Weight loss, specifically loss of body fat, is associated with benefits in all of the obesity-related comorbidities, but, unfortunately, most weight loss interventions are associated with weight regain and are therefore not successful in the long term. It is for these reasons that efforts to prevent weight gain and overweight/ obesity are necessary. This is especially important when one considers younger individuals, who have even more to lose as a consequence of a longer duration of excess adiposity.After a brief review of the epidemiology of obesity, this statement will make the case for the importance of weight gain prevention. This argument will first include a review of the complications of overweight and obesity in both adults and children, including the future CVD risks of obesity in early life. Energy balance dysregulation and adaptations to the weight-reduced state, favoring weight regain, will then be reviewed as further argument for the need for obesity prevention. This will be followed by a discussion on the goals and strategies for accomplishing the difficult task of the prevention of weight gain and obesity. Scope of the Problem Classification of Overweight and ObesityThe body mass index (BMI) is the most widely used and accepted method for the assessment and classification of excess adiposity or body fatness. Overweight and obesity are classified according to BMI for adults. 1 A BMI Ͻ18.5 kg/m 2 is considered underweight, between 18.5 and 24.9 kg/m 2 corresponds to a healthy weight, between 25.0 and 29.9 kg/m 2 is overweight, and Ն30.0 kg/m 2 is obese. Obesity is further classified as stage I or mild (BMI of 30.0 to 34.9 kg/m 2 ), stage II or moderate (BMI of 35.0 to 39.9 kg/m 2 ), and stage III or severe (BMI of Ն40.0 kg/m 2 ). In children, BMI percentiles adjusted for age and sex and calculated on the basis of a compilation of national survey data collected over a 30-year period are used. In children aged 2 to 19 years, overweight is defined as a BMI between the 85th and 95th percentiles, and obesity is defined as a BMI Ն95th percentile. 2 Epidemiology of Overweight and ObesityThe prevalence of overweight and obesity in the United States and the world has risen dramatically over the last 4 to 5 decades and has been summarized. 3,4 In the most recent US population estimates based on data from the 2007-2008 National Health and Nutri...

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“…Also in the case of obesity, the current data regarding increased incidence of diverticulosis is inhomogeneous and questionable. Therefore, no relevant connection between BMI and diverticulosis could be shown in a prospective cohort study and a cross-sectional study [18,20].…”

mentioning

confidence: 97%

S2k Guidlines for Diverticular Disease and Diverticulitis: Diagnosis, Classification, and Therapy for the Radiologist

Schreyer

Layer

2015

Fortschr Röntgenstr

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Diverticular disease and diverticulitis represent an increasingly common disease especially in patients with advanced age. The German Society of Digestive and Metabolic Diseases (DGVS) as well as the German Society of General and Visceral Surgery (DGAV) in collaboration with the German Radiology Society (DRG) created and published S2k guidelines regarding this topic. Knowledge of the diagnosis and therapy of this common disease is extremely important for the radiologist for the daily clinical routine. In this article we review and discuss the most important clinical situations and algorithms of this disease focusing on radiological topics. Additionally, we introduce the new CCD (classification of diverticular disease) system regarding radiology. Key Points: ??For the diagnosis of a diverticular disease a sectional imaging method should be performed. First choice should be a ?qualified ultrasound examination? followed by CT in uncertain situations or complicated disease. ??Disease classification should be done according the new CCD (Classification of diverticular disease) algorithm. ??Based on this new CCD patients can be stratified into outpatient, in-house patient and surgical treatment therapy. Citation Format: ??Schreyer AG, Layer G. S2k Guidlines for Diverticular Disease and Diverticulitis: Diagnosis, Classification, and Therapy for the Radiologist. Fortschr R?ntgenstr 2015; 187: 676???684

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Obesity Increases the Risks of Diverticulitis and Diverticular Bleeding

Cited by 358 publications

References 52 publications

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

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

Prevention of Overweight/Obesity as a Strategy to Optimize Cardiovascular Health

S2k Guidlines for Diverticular Disease and Diverticulitis: Diagnosis, Classification, and Therapy for the Radiologist

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