Segmentation and the Localization of Intraluminal Pressures in the Human Colon, with Special Reference to the Pathogenesis of Colonic Diverticula

Painter, Neil S.; Truelove, S. C.; Ardran, G. M.; Tuckey, M.

doi:10.1016/s0016-5085(19)34563-9

Cited by 233 publications

(90 citation statements)

References 11 publications

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“…On the one hand, mechanical factors have been reported. It has been demonstrated that the intraluminal pressure within the sigmoid colon of persons with diverticulosis during periods of peak contraction resulted in pressures of up to 90 mmHg, a value nine times higher than those in colons not affected by diverticulosis [6]. This may lead to herniation of the mucosa through the muscle in areas of weakness, which are represented by the areas of penetration of the vasa recta [8,19].…”

Section: Discussionmentioning

confidence: 99%

“…One is an inadequately high intraluminal pressure within the sigmoid colon of persons with diverticula during periods of peak contraction. This is thought to lead to herniation of the mucosa through the muscle in areas of weakness, represented by the vasa recta [6]. Other factors in the pathogenesis focus on fiber deficiency, today a well-established concept [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Increased distribution of collagen type III and reduced expression of matrix metalloproteinase 1 in patients with diverticular disease

Stumpf¹,

Cao²,

Klinge³

et al. 2001

Int J Colorectal Dis

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Diverticular disease is an increasingly common clinical problem especially in Western industrialized countries, but the mechanism by which the disease develops remains unclear. Based on studies showing a structural change in the colonic wall in these patients, we examined whether there are any disorders concerning the collagen metabolism in patients with diverticular disease. Samples of colonic tissue from 13 patients with diverticulitis were compared to 14 controls. We performed a Sirius red test for the overall collagen content and immunohistochemical studies facing differentiation between collagen type I and type III and the expression of matrix metalloproteinases 1 and 13. In the bowel sections of patients with diverticulitis there were decreased levels of mature collagen type I (1.37+/- 0.32 vs. 1.59 +/- 0.31) and increased levels of collagen type III (1.61+/- 0.32 vs. 1.42 +/- 0.42), with a resulting lower collagen ratio I/III. The expression of MMP-I was reduced significantly in the diverticulitis group (4.83 +/- 0.92 vs. 6.02 +/- 1.98) while expression of MMP-13 did not differ significantly between the two groups (1.03 +/- 0.11 vs. 1.04 +/- 0.12). Our findings support the theory of structural changes in the colonic wall as one of the major pathogenic factors in the development of diverticular disease. Further studies must focus on the complex interactions of several extracellular matrix components.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased distribution of collagen type III and reduced expression of matrix metalloproteinase 1 in patients with diverticular disease

Stumpf¹,

Cao²,

Klinge³

et al. 2001

Int J Colorectal Dis

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“…This results in raising the intracolonic pressure, generating increased outward force on the colon wall, leading to mucosal herniation. 16,17 Since these original descriptions linking intracolonic pressure to diverticula formation, other more recent demonstrations have confirmed that higher pressures and an exaggerated motility index (product of amplitude and duration of activity) occur in patients with symptomatic diverticular disease. 18,19 Still others seem more skeptic of a hallmark connection between diverticular disease and altered colonic motility.…”

Section: Pathogenesis Of Diverticulosis and Diverticulitismentioning

confidence: 97%

Epidemiology and Pathogenesis of Diverticular Disease

Heise

2008

Journal of Gastrointestinal Surgery

102

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Diverticular disease is a common entity in the USA with an apparent increasing incidence worldwide. The pathogenesis of this disease process is likely multifactorial involving dietary habits, changes in colonic pressures and motility, and colon wall structural changes associated with aging. The following review addresses our current limited knowledge regarding the epidemiology and pathogenesis of diverticulosis and diverticulitis.

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“…DF intake increases fecal weight and softens the feces, and it is believed that this might assist DF to prevent many colonic diseases such as cancer or diverticulosis [1,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Effects of Cellulose Supplementation on Fecal Consistency and Fecal Weight

et al. 2007

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We investigated the effects of cellulose supplementation on fecal consistency and fecal weight. About 26 women were classified into two groups-normal defecation and constipation groups. All subjects ate the following meals during the experiment: ordinary meals (first week), experimental meals (second week), and experimental meals mixed with 4 g (third week) and 8 g (fourth week) cellulose. The experimental meal contained 16.7 g fiber. Fecal weights, fecal water content, fecal consistency, and defecation frequency were measured during the experimental period. As a result, in the normal defecation group, the mean fecal weight was 222.9 g day(-1) in the first week, and thereafter decreased. Although 20/24 g of fiber intake in the third/fourth week increased the fecal weight to over 150 g, the fecal consistency was still lower than the optimal consistency of around 300 g cm(-2). However, these changes were not observed in the constipated group.

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Segmentation and the Localization of Intraluminal Pressures in the Human Colon, with Special Reference to the Pathogenesis of Colonic Diverticula

Cited by 233 publications

References 11 publications

Increased distribution of collagen type III and reduced expression of matrix metalloproteinase 1 in patients with diverticular disease

Increased distribution of collagen type III and reduced expression of matrix metalloproteinase 1 in patients with diverticular disease

Epidemiology and Pathogenesis of Diverticular Disease

Effects of Cellulose Supplementation on Fecal Consistency and Fecal Weight

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