Skip to main content
Erschienen in: Techniques in Coloproctology 3/2016

01.03.2016 | Original Article

Risk factors associated with colonic diverticulosis among patients from a defined geographic area

verfasst von: M. P. Dore, G. M. Pes, G. Marras, S. Soro, C. Rocchi, M. F. Loria, G. Bassotti

Erschienen in: Techniques in Coloproctology | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

Only a few data regarding colonic diverticulosis are available in Italy. We examined the frequency of colonic diverticulosis and its associations with risk factors in a homogeneous Northern Sardinian population undergoing colonoscopy for any reason in the last decades.

Methods

This was a retrospective single-center study. Medical records of patients undergoing colonoscopy for any indication between 1995 and 2013 were reviewed. Demographic information including age, gender, geographic area (urban, rural), marital status, smoking habit, occupation, body mass index, and comorbidities were collected. Presence, number, and extension of diverticula were assessed by colonoscopy. The diagnosis of diverticulosis was defined by the presence of more than five diverticula.

Results

A total of 4458 records were collected (39.8 % males). Analysis by birth cohorts showed a significant progressive age-related increase in the prevalence of diverticulosis. The average prevalence was 18.9 % without significant variation across the 19-year observation period. In 101 (12.1 %) subjects diverticula were single or few. Seventy-one percent of diverticula were located predominantly in the left side, 2 % in the right side, and 14.3 % were spread throughout the colon. There was a significant association with obesity but not with smoking habits, marital status, or urban versus rural environment. A strong association was observed between the presence of diverticulosis and cardiovascular and other gastrointestinal and lung disease (p < 0.0001). These associations were also confirmed by the logistic regression analysis.

Conclusions

In this endoscopic study, colonic diverticulosis in Northern Sardinia showed prevalence similar to other series in Western countries, and it was predominantly left sided and age related.
Literatur
1.
Zurück zum Zitat Everhart JE, Ruhl CE (2009) Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas. Gastroenterology 136:1134–1144CrossRefPubMed Everhart JE, Ruhl CE (2009) Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas. Gastroenterology 136:1134–1144CrossRefPubMed
2.
Zurück zum Zitat Cuomo R, Barbara G, Pace F et al (2014) Italian consensus conference for colonic diverticulosis and diverticular disease. United Eur Gastroenterol J 2:413–442CrossRef Cuomo R, Barbara G, Pace F et al (2014) Italian consensus conference for colonic diverticulosis and diverticular disease. United Eur Gastroenterol J 2:413–442CrossRef
3.
Zurück zum Zitat Jeyarajah S, Faiz O, Bottle A et al (2009) Diverticular disease hospital admissions are increasing, with poor outcomes in the elderly and emergency admissions. Aliment Pharmacol Ther 30:1171–1182CrossRefPubMed Jeyarajah S, Faiz O, Bottle A et al (2009) Diverticular disease hospital admissions are increasing, with poor outcomes in the elderly and emergency admissions. Aliment Pharmacol Ther 30:1171–1182CrossRefPubMed
4.
5.
Zurück zum Zitat Gear JS, Ware A, Fursdon P et al (1979) Symptomless diverticular disease and intake of dietary fibre. Lancet 1:511–514CrossRefPubMed Gear JS, Ware A, Fursdon P et al (1979) Symptomless diverticular disease and intake of dietary fibre. Lancet 1:511–514CrossRefPubMed
6.
Zurück zum Zitat Eastwood MA, Sanderson J, Pocock SJ, Mitchell WD (1977) Variation in the incidence of diverticular disease within the city of Edinburgh. Gut 18:571–574PubMedCentralCrossRefPubMed Eastwood MA, Sanderson J, Pocock SJ, Mitchell WD (1977) Variation in the incidence of diverticular disease within the city of Edinburgh. Gut 18:571–574PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Lohsiriwat V, Suthikeeree W (2013) Pattern and distribution of colonic diverticulosis: analysis of 2877 barium enemas in Thailand. World J Gastroenterol 19:8709–8713PubMedCentralCrossRefPubMed Lohsiriwat V, Suthikeeree W (2013) Pattern and distribution of colonic diverticulosis: analysis of 2877 barium enemas in Thailand. World J Gastroenterol 19:8709–8713PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Lahiri RP, Abeles A, Burnand KM et al (2013) A cross sectional study of colonic diverticulosis in the London Bangladeshi population. United Eur Gastroenterol J 1:191–197CrossRef Lahiri RP, Abeles A, Burnand KM et al (2013) A cross sectional study of colonic diverticulosis in the London Bangladeshi population. United Eur Gastroenterol J 1:191–197CrossRef
9.
Zurück zum Zitat Azzam N, Aljebreen AM, Alharbi O, Almadi MA (2013) Prevalence and clinical features of colonic diverticulosis in a Middle Eastern population. World J Gastrointest Endosc 5:391–397PubMedCentralCrossRefPubMed Azzam N, Aljebreen AM, Alharbi O, Almadi MA (2013) Prevalence and clinical features of colonic diverticulosis in a Middle Eastern population. World J Gastrointest Endosc 5:391–397PubMedCentralCrossRefPubMed
10.
Zurück zum Zitat Nagata N, Niikura R, Aoki T et al (2014) Increase in colonic diverticulosis and diverticular hemorrhage in an aging society: lessons from a 9-year colonoscopic study of 28,192 patients in Japan. Int J Colorectal Dis 29:379–385CrossRefPubMed Nagata N, Niikura R, Aoki T et al (2014) Increase in colonic diverticulosis and diverticular hemorrhage in an aging society: lessons from a 9-year colonoscopic study of 28,192 patients in Japan. Int J Colorectal Dis 29:379–385CrossRefPubMed
11.
Zurück zum Zitat Paspatis GA, Papanikolaou N, Zois E, Michalodimitrakis E (2001) Prevalence of polyps and diverticulosis of the large bowel in the Cretan population. An autopsy study. Int J Colorectal Dis 16:257–261CrossRefPubMed Paspatis GA, Papanikolaou N, Zois E, Michalodimitrakis E (2001) Prevalence of polyps and diverticulosis of the large bowel in the Cretan population. An autopsy study. Int J Colorectal Dis 16:257–261CrossRefPubMed
12.
Zurück zum Zitat Blachut K, Paradowski L, Garcarek J (2004) Prevalence and distribution of the colonic diverticulosis. Review of 417 cases from Lower Silesia in Poland. Rom J Gastroenterol 13:281–285PubMed Blachut K, Paradowski L, Garcarek J (2004) Prevalence and distribution of the colonic diverticulosis. Review of 417 cases from Lower Silesia in Poland. Rom J Gastroenterol 13:281–285PubMed
13.
Zurück zum Zitat Meurs-Szojda MM, Terhaar sive Droste JS, Kuik DJ, Mulder CJ, Felt-Bersma RJ (2008) Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4241 colonoscopies. Int J Colorectal Dis 23:979–984CrossRefPubMed Meurs-Szojda MM, Terhaar sive Droste JS, Kuik DJ, Mulder CJ, Felt-Bersma RJ (2008) Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4241 colonoscopies. Int J Colorectal Dis 23:979–984CrossRefPubMed
14.
Zurück zum Zitat Faucheron JL, Roblin X, Bichard P, Heluwaert F (2013) The prevalence of right-sided colonic diverticulosis and diverticular haemorrhage. Colorectal Dis 15:e266–e270CrossRefPubMed Faucheron JL, Roblin X, Bichard P, Heluwaert F (2013) The prevalence of right-sided colonic diverticulosis and diverticular haemorrhage. Colorectal Dis 15:e266–e270CrossRefPubMed
15.
Zurück zum Zitat De Cecco CN, Ciolina M, Annibale B et al (2015) Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC). Eur Radiol. doi:10.1007/s00330-015-3866-1 De Cecco CN, Ciolina M, Annibale B et al (2015) Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC). Eur Radiol. doi:10.​1007/​s00330-015-3866-1
16.
Zurück zum Zitat Dore MP, Bilotta M, Malaty HM et al (2000) Diabetes mellitus and Helicobacter pylori infection. Nutrition 16:407–410CrossRefPubMed Dore MP, Bilotta M, Malaty HM et al (2000) Diabetes mellitus and Helicobacter pylori infection. Nutrition 16:407–410CrossRefPubMed
17.
Zurück zum Zitat Pardo LM, Piras G, Asproni R et al (2012) Dissecting the genetic make-up of North-East Sardinia using a large set of haploid and autosomal markers. Eur J Hum Gene 20:956–964CrossRef Pardo LM, Piras G, Asproni R et al (2012) Dissecting the genetic make-up of North-East Sardinia using a large set of haploid and autosomal markers. Eur J Hum Gene 20:956–964CrossRef
18.
Zurück zum Zitat Halligan S, Saunders B (2002) Imaging diverticular disease. Best Pract Res Clin Gastroenterol 16:595–610CrossRefPubMed Halligan S, Saunders B (2002) Imaging diverticular disease. Best Pract Res Clin Gastroenterol 16:595–610CrossRefPubMed
19.
Zurück zum Zitat Pes GM, Tolu F, Dore MP et al (2015) Male longevity in Sardinia. A review of historical sources supporting a causal link with dietary factors. Eur J Clin Nutr 69:411–418CrossRefPubMed Pes GM, Tolu F, Dore MP et al (2015) Male longevity in Sardinia. A review of historical sources supporting a causal link with dietary factors. Eur J Clin Nutr 69:411–418CrossRefPubMed
20.
Zurück zum Zitat Jeyarajah S, Papagrigoriadis S (2008) Diverticular disease increases and effects younger ages: an epidemiological study of 10-year trends. Int J Colorectal Dis 23:619–627CrossRefPubMed Jeyarajah S, Papagrigoriadis S (2008) Diverticular disease increases and effects younger ages: an epidemiological study of 10-year trends. Int J Colorectal Dis 23:619–627CrossRefPubMed
21.
Zurück zum Zitat Yamamichi N, Shimamoto T, Takahashi Y et al (2015) Trend and risk factors of diverticulosis in Japan: age, gender, and lifestyle/metabolic-related factors may cooperatively affect on the colorectal diverticula formation. PLoS ONE 10:e0123688PubMedCentralCrossRefPubMed Yamamichi N, Shimamoto T, Takahashi Y et al (2015) Trend and risk factors of diverticulosis in Japan: age, gender, and lifestyle/metabolic-related factors may cooperatively affect on the colorectal diverticula formation. PLoS ONE 10:e0123688PubMedCentralCrossRefPubMed
22.
Zurück zum Zitat Crowe FL, Appleby PN, Allen NE, Key TJ (2011) Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ 343:d4131PubMedCentralCrossRefPubMed Crowe FL, Appleby PN, Allen NE, Key TJ (2011) Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ 343:d4131PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Spiller RC (2015) Changing views on diverticular disease: impact of aging, obesity, diet, and microbiota. Neurogastroenterol Motil 27:305–312CrossRefPubMed Spiller RC (2015) Changing views on diverticular disease: impact of aging, obesity, diet, and microbiota. Neurogastroenterol Motil 27:305–312CrossRefPubMed
24.
Zurück zum Zitat Hjern F, Wolk A, Håkansson N (2011) Smoking and the risk of diverticular disease in women. Br J Surg 98:997–1002CrossRefPubMed Hjern F, Wolk A, Håkansson N (2011) Smoking and the risk of diverticular disease in women. Br J Surg 98:997–1002CrossRefPubMed
25.
Zurück zum Zitat Hjern F, Wolk A, Håkansson N (2012) Obesity, physical inactivity, and colonic diverticular disease requiring hospitalization in women: a prospective cohort study. Am J Gastroenterol 107:296–302CrossRefPubMed Hjern F, Wolk A, Håkansson N (2012) Obesity, physical inactivity, and colonic diverticular disease requiring hospitalization in women: a prospective cohort study. Am J Gastroenterol 107:296–302CrossRefPubMed
26.
Zurück zum Zitat Usai P, Ibba I, Lai M et al (2011) Cigarette smoking and appendectomy: effect on clinical course of diverticulosis. Dig Liver Dis 43:98–101CrossRefPubMed Usai P, Ibba I, Lai M et al (2011) Cigarette smoking and appendectomy: effect on clinical course of diverticulosis. Dig Liver Dis 43:98–101CrossRefPubMed
27.
Zurück zum Zitat Rosemar A, Angerås U, Rosengren A (2008) Body mass index and diverticular disease: a 28-year follow-up study in men. Dis Colon Rectum 51:450–455CrossRefPubMed Rosemar A, Angerås U, Rosengren A (2008) Body mass index and diverticular disease: a 28-year follow-up study in men. Dis Colon Rectum 51:450–455CrossRefPubMed
28.
Zurück zum Zitat Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL (2009) Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology 136:115–122PubMedCentralCrossRefPubMed Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL (2009) Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology 136:115–122PubMedCentralCrossRefPubMed
29.
Zurück zum Zitat Song JH, Kim YS, Lee JH et al (2010) Clinical characteristics of colonic diverticulosis in Korea: a prospective study. Korean J Intern Med 25:140–146PubMedCentralCrossRefPubMed Song JH, Kim YS, Lee JH et al (2010) Clinical characteristics of colonic diverticulosis in Korea: a prospective study. Korean J Intern Med 25:140–146PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Bassotti G, Villanacci V (2012) Colonic diverticular disease: abnormalities of neuromuscular function. Dig Dis 30:24–28CrossRefPubMed Bassotti G, Villanacci V (2012) Colonic diverticular disease: abnormalities of neuromuscular function. Dig Dis 30:24–28CrossRefPubMed
31.
Zurück zum Zitat Golder M, Burleigh DE, Belai A et al (2003) Smooth muscle cholinergic denervation hypersensitivity in diverticular disease. Lancet 361:1945–1951CrossRefPubMed Golder M, Burleigh DE, Belai A et al (2003) Smooth muscle cholinergic denervation hypersensitivity in diverticular disease. Lancet 361:1945–1951CrossRefPubMed
32.
Zurück zum Zitat Mattii L, Ippolito C, Segnani C et al (2013) Altered expression pattern of molecular factors involved in colonic smooth muscle functions: an immunohistochemical study in patients with diverticular disease. PLoS ONE 8:e57023PubMedCentralCrossRefPubMed Mattii L, Ippolito C, Segnani C et al (2013) Altered expression pattern of molecular factors involved in colonic smooth muscle functions: an immunohistochemical study in patients with diverticular disease. PLoS ONE 8:e57023PubMedCentralCrossRefPubMed
33.
Zurück zum Zitat Monk BA, George SJ (2015) The effect of ageing on vascular smooth muscle cell behaviour—a mini-review. Gerontology 61:416–426CrossRefPubMed Monk BA, George SJ (2015) The effect of ageing on vascular smooth muscle cell behaviour—a mini-review. Gerontology 61:416–426CrossRefPubMed
34.
Zurück zum Zitat Tursi A (2015) The role of colonoscopy in managing diverticular disease of the colon. J Gastrointestin Liver Dis 24:85–93PubMed Tursi A (2015) The role of colonoscopy in managing diverticular disease of the colon. J Gastrointestin Liver Dis 24:85–93PubMed
Metadaten
Titel
Risk factors associated with colonic diverticulosis among patients from a defined geographic area
verfasst von
M. P. Dore
G. M. Pes
G. Marras
S. Soro
C. Rocchi
M. F. Loria
G. Bassotti
Publikationsdatum
01.03.2016
Verlag
Springer Milan
Erschienen in
Techniques in Coloproctology / Ausgabe 3/2016
Print ISSN: 1123-6337
Elektronische ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-015-1401-7

Weitere Artikel der Ausgabe 3/2016

Techniques in Coloproctology 3/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.