The Natural History of Incidental Colonic Diverticulosis on Screening Colonoscopy

Sharara, Ala I.; Ziade, Nathalie; Shayto, Rani; Rustom, Luma Basma O.; Chehab, Hamed; Rimmani, Hussein H.; Hanna, Krystelle; Chalhoub, Jean M.; Sarkis, Fayez; Rahal, Mahmoud; Soweid, Assaad; Mourad, Fadi H.; Barada, Kassem; Harb, Ali H.

doi:10.1155/2018/3690202

Cited by 11 publications

(6 citation statements)

References 20 publications

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“…The incidence of diverticular disease has been increasing in both Europe and the United States[ 3 ]. Although acute right-sided colonic diverticulitis (ARCD) is still considered a rare disease in the western world, the real incidence is not that rare[ 38 ] ranging from 5% to 20%[ 3 , 5 , 28 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Right sided diverticulitis in western countries: A review

Epifani¹,

Cassini²,

Cirocchi³

et al. 2021

WJGS

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BACKGROUND Although the treatment guidelines for left sided diverticulitis are clear, the management of right colonic diverticulitis is not well established. This disease can no longer be ignored due to significant spread throughout Asia. AIM To analyse epidemiology, diagnosis and treatment of right-sided diverticulitis in western countries. METHODS MEDLINE and PubMed searches were performed using the key words “right-sided diverticulitis’’, ‘‘right colon diverticulitis’’, ‘‘caecal diverticulitis’’, ‘‘ascending colon diverticulitis’’ and ‘‘caecum diverticula’’ in order to find relevant articles published until 2021. RESULTS A total of 18 studies with 422 patients were found. Correct diagnosis was made only in 32.2%, mostly intraoperatively or via CT scan. The main reason for misdiagnosis was a suspected acute appendicitis (56.8%). The treatment was a non-operative management (NOM) in 184 patients (43.6%) and surgical in 238 patients (56.4%), seven of which after NOM failure. Recurrence rate was low (5.45%), similar to eastern studies and inferior to left -sided diverticulitis. Recurrent patients were successfully conservatively retreated in most cases . CONCLUSION The management of right- sided diverticulitis is not well clarified in the western world and no selective guidelines have been considered even if principles are similar to those with left- sided diverticulitis. Wrong diagnosis is one of the most important problems and CT scan seems to be the best imaging modality. NOM offers a safe and effective treatment; surgery should be considered only in cases of complicated diverticulitis or if malignancy cannot be excluded. Further studies are needed to clarify the correct treatment.

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Section: Discussionmentioning

confidence: 99%

Right sided diverticulitis in western countries: A review

Epifani¹,

Cassini²,

Cirocchi³

et al. 2021

WJGS

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“…In another study, of 144 patients detected with asymptomatic DD in a screening colonoscopy study and over a mean follow-up of 7.0±1.7 years, 4.2% developed AD or diverticular bleeding. No variables, including constipation, collected at baseline colonoscopy were associated with these events [24] In a Norwegian population based study conducted to detect risk factors of hospital admission for AD, increased age, obesity, smoking in females and living in rural areas in males, but not constipation were associated with increased risk [25]. In a small study conducted in Asiatic Korean people, constipation was not associated with the development of rightsided diverticulitis [26].…”

Section: What Determines the Evolution To Diverticulitis?mentioning

confidence: 97%

Course of the Diverticular Disease: What is changing?

Milosavljević¹,

Brandimarte²,

Stollman³

et al. 2020

JGLD

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In this session several critical issues in diverticular disease were considered, including “It is Symptomatic Diverticular Disease or Irritable Bowel Syndrome?”, “What do determine evolution to diverticulitis, bowel habits alteration or inflammation?”, and “Prevention of acute diverticulitis: Is it at all possible?”. The first talking compared symptoms and laboratory findings between Symptomatic Uncomplicated Diverticular Disease (SUDD) and Irritable Bowel Syndrome (IBS). Although both disease share some symptoms, and although IBS can occur in patients having diverticulosis, SUDD and IBS can be differentiate using a combination of symptoms and laboratory tools. The second talking debated what are the most important risk factors for the evolution towards acute diverticulitis. Current data seem to exclude a significant role of bowel habits alteration, while inflammation seems to have a stronger role, especially in causing acute diverticulitis recurrence. The third talking analyzed about the acute diverticulitis prevention. Primary prevention seem to be little better when using mesalazine, while no definite conclusion can be drawn about the use of fiber and rifaximin. About the secondary prevention, no drugs can be currently advised due to lacking of definite results. At the same time, surgery should be advised on case-by-case basis.

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“…A recent study showed that the prevalence of colonic diverticulosis is increasing worldwide, particularly in developed western countries [ 1 , 2 ]. The prevalence is low in some Asian countries; however, it has increased recently [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Association between serum uric acid levels and colonic diverticulosis in terms of sex

Chang

Shih

et al. 2022

PLoS ONE

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Background The association between elevated serum uric acid (UA) levels and the risk of developing colonic diverticulosis has not yet been investigated. Thus, this cross-sectional study aimed to examine this correlation in individuals from Taiwan. Methods From Jan. 1, 2010, to Dec. 31, 2016., approximately 5,605 patients (aged >20 years) from Tri-Service General Hospital who met the inclusion criteria according to colonoscopy and laboratory test findings were included in this research. The correlation between serum UA levels and colonic diverticulosis was investigated via regression analyses. Results Participants with elevated serum UA levels were at a higher risk of colonic diverticulosis. The area under the curve for serum UA levels was significantly higher in women than in men (0.651 [95% confidence interval: 0.596–0.707] vs. 0.55 [0.507–0.593]). There were specific trends in female-specific indicators for colonic diverticulosis across increasing quartiles of serum UA levels. Conclusions Patients with elevated serum UA levels should be cautious regarding the development of colonic diverticulosis disorder in female. Moreover, prospective studies may provide additional information on the relationship between elevated serum UA levels and colonic diverticulosis.

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The Natural History of Incidental Colonic Diverticulosis on Screening Colonoscopy

Cited by 11 publications

References 20 publications

Right sided diverticulitis in western countries: A review

Right sided diverticulitis in western countries: A review

Course of the Diverticular Disease: What is changing?

Association between serum uric acid levels and colonic diverticulosis in terms of sex

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