Pathophysiological aspects of diverticular disease of colon and role of large bowel motility

Abstract

Colonic diverticular disease (diverticulosis) is one of the most common gastrointestinal disorders in Western countries. This disorder is strictly related to aging and fibre intake, and still bears a discrete amount of morbidity. Numerous etiological co-factors have to date been implicated in the pathogenesis of the disease, yet the supporting evidence is still far from absolute. The present review considers the pathophysiology of colonic diverticular disease, with a special emphasis on factors related to abnormal colonic motility.Bassotti G, Chistolini F, Morelli A. Pathophysiological aspects of diverticular disease of colon and role of large bowel motility.

Tachykinin NK2Receptor and Functional Mechanisms in Human Colon: Changes with Indomethacin and in Diverticular Disease and Ulcerative Colitis

“…Motility changes have been reported in patients with DD (Bassotti et al, 2003) as well as UC (reviewed in Lecci et al, 2006). Bassotti et al (2005) have reported a decrease in interstitial cells of Cajal and glial cells in DD, but no change in enteric neurons, and suggested that these changes might underlie the motor abnormalities found in DD.…”

Absence of Mucosal Inflammation in Uncomplicated Diverticular Disease

“…It is mainly localised in the left colon (descending colon and sigma) and characterised by mucosal pockets within the colonic wall around the weak zones of penetration of the vasa recta through the muscolaris propria [1][2][3]. Once diverticula are formed, they can remain asymptomatic, become symptomatic in 20% of patients [4], or can evolve toward a diverticulitis possibly complicated by abscess, obstruction, fistulization, bleeding, sepsis, or strictures (uncomplicated or complicated diverticular disease, UDD or CDD) [5].…”

Mesalazine for diverticular disease of the colon – a new role for an old drug

“…The results obtained in this study confirm this synergistic effect: rifaximin should eliminate the microflora (which seem to play a key role in determining both symptoms and inflammation related to diverticular disease) [5] and mesalazine should reduce the effect of the inflammatory cascade. These results are very interesting, as patients with recurrent attacks of diverticulitis may progressively be affected by fibrosis and stricturing of the colonic wall, with a consequent bacterial colonic overgrowth [30]. In such cases, high grade or complete obstruction can occur, rendering medical therapy ineffective and requiring surgery.…”