Pathogenese und Epidemiologie der Sigmadivertikulose

Abstract

From an epidemiological point of view, left-sided diverticulosis represents a civilizational disease of Western countries. It occurs rarely during childhood and frequently in later years. A diet high in fat and meat, low in vegetables, and with insufficient fiber content apparently encourages its genesis. Physical activity seems to counteract diverticulosis while alcohol consumption, smoking, and caffeine ingestion have no effect. The extent of diverticulosis is not commensurate with the extent of complaints. Only a few patients with diverticula develop diverticulitis. Pathogenetically, several factors play a role in the development of diverticulosis. Elevated intraluminal pressure as well as acquired structural changes of the intestinal wall seem to be decisive factors, which intensify with increasing age. These changes are caused by ultrastructural alterations of the muscle and connective tissue related to collagen and elastin metabolism, which presumably can be genetically determined. Intestinal disturbances of innervation and motility also contribute to the formation of diverticula. The term "hypersegmentation" is an attempt to combine these factors into a single pathogenetic model.

Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

“…c Due to the high-grade narrowing of the sigmoid colon conventional colonoscopy was incomplete. On the coronal source image a contrast enhancing lesion in the cecum is seen (arrow) DD of the right colon is the most common colonic disease in Western countries, affecting 10-50% of those aged over 60 years [1][2][3][4][5]. The pathophysiology of DD varies in a complex relationship between age, fiber diet, and transit time of the feces [1,7].…”

“…A true diverticulum is defined as a herniation of the mucous membrane of the colonic wall including mucosa, muscularis mucosae, and submucosa through the circular muscularis propia and is usually located in the central portion of the interhaustral segments [1][2][3][4][5]. Various hypotheses have been suggested regarding the cause of colonic diverticulosis, including advanced age, high pressure within the large bowel, prolonged gastrointestinal transit time, fiber-deficient diet, and hereditary diseases [6,7].…”

Clinical use of MRI: Virtual Dark-Lumen MR Colonography: Technique, Application and Accuracy

“…A true diverticulum is defined as a herniation the mucous membrane of the colonic wall including mucosa, muscularis mucosae and submucosa through the circular muscularis propia, and it is mainly located in the central portion of the interhaustral segments (42)(43)(44)(45)(46). The hypotheses on the etiology of colonic diverticulosis are variant including high age, high pressure within the large bowel, prolonged gastrointestinal transit time, fibredeficient diet and hereditary diseases.…”

Regeneration of Colorectal Epithelium in Diverticulosis

“…Asymptomatic complications often develop. The diverticula are fraught with complications: hemorrhages, perforations, infl ammations [11,14]. The knowledge of the pathogenetic mechanisms of destructive changes in the intestinal wall and the processes regulating the compensatory and adaptive reactions is insuffi cient for effective prevention of complications.…”