Pathophysiology and Epidemiology of Diverticular Disease

Abstract

Diverticular disease exists on a spectrum, ranging from asymptomatic diverticulosis to complicated diverticulitis. Incidence of diverticulitis in western nations has increased in recent years, although the factors that influence the progression from diverticulosis to diverticulitis are unknown. Geographic/environmental influences, lifestyle variables, and microbiota of the gastrointestinal tract are some of the factors implicated in diverticular disease.

Divertikulosis dan Divertikulitis

“…Dewasa ini sulit untuk memperkirakan jumlah orang yang terkena penyakit divertikulosis karena tahap awal dari penyakit yang cenderung asimtomatik. Diperkirakan sekitar 20% pasien divertikulosis mengalami peradangan atau infeksi simtomatik yang disebut dengan divertikulitis (Talutis & Kuhnen, 2021). Prevalensi divertikulosis di negara-negara barat adalah sebesar 4 -45% dan terus mengalami peningkatan dari pertengahan tahun 1990 hingga sekarang.…”

“…Secara fungsional, sekum dan asenden adalah lokasi utama terjadinya fermentasi bakteri karbohidrat dan protein sehingga tetap terisi sepanjang teniae dan plica circulares dalam jangka waktu cukup lama untuk memungkinkan aktivitas mikroba. Reabsorbsi air dan elektrolit mengurangi jumlah feses pada saat mencapai kolon desendens yang merupakan reservoir feses sebelum defekasi (Talutis & Kuhnen, 2021).…”

“…Jika feses terperangkap dalam divertikula, akan menyebabkan tekanan di sepanjang dinding colon yang berisi divertikula. Apabila tekanan terjadi secara persisten, akan menimbulkan ulserasi dan perforasi (Talutis & Kuhnen, 2021).…”

Lactobacillus paracasei CNCM I 1572: A Promising Candidate for Management of Colonic Diverticular Disease

“…Diverticular disease (DD) is a spectrum of gastrointestinal conditions characterized by the presence of diverticula, defined as small, balloon-like sacs protruding through the layers of the colon [ 1 ]. DD is the fifth most important gastrointestinal disease in terms of healthcare costs in Western countries, with the highest rates occurring in the United States and Europe with 60–70% prevalence rates in those older than 60 [ 1 , 2 ]. The presence of one or more diverticula in the colon is called diverticulosis [ 2 , 3 ].…”

“…Approximately 20% of patients with DD develop symptoms, including abdominal pain, bloating, and altered bowel habits, the condition is called symptomatic uncomplicated diverticular disease (SUDD) [ 1 , 2 ]. The major clinical complication, occurring in about 4% of individuals, is acute diverticulitis, that could be uncomplicated or complicated by abscess formation, haemorrhage, and perforation [ 1 , 5 , 6 ]. Moreover, due to persistent mucosal inflammation, patients with acute diverticulitis may be susceptible to the consecutive development of SUDD [ 7 ].…”