Wednesday, 4 December 2013

Diverticulitis – Diseases associated with Diverticulitis

Diverticulitis is defined as a condition of inflammation of the small, bulging sacs or pouches of the inner lining of the intestine that bulge outward through weak spots as a result of small pieces of stool (feces) trapped in these pouches. In most cases, the disease is found in the large intestine (colon). According to the statistic, approximately, About 10 percent of Americans older than 40 have diverticulosis.
In the examination of the data fom January 2004 to June 2005 of 796 consecutive patients referred for total colonoscopy to 17 physicians included age, gender, presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding, showed that the prevalence of colonic diverticula increased from less than 10% in adults under 40 to about 75% in those over 75 years. Of these patients, nearly one third presented with right-sided involvement(1).
B. Diseases associated with Diverticulitis
1. Stenosis
The incidence of colonic diverticulosis with or without diverticulitis has increased in the Japanese population due to the modernization of food and aging. The rate of diverticulitis in colon diverticulosis ranges from 8.1% to 9.6%. However, few cases of stenosis due to diverticulitis have been reported(26).
2. Advanced colonic neoplasia
According to the study of 1,326 patients-56% male (n=741), 44% female (n=585), mean age 64 (+/-11.83 SD)-with a resection due to colonic cancer, the documented findings of colonoscopy, colonic contrast enema, and/or histopathology were analysed with regard to the prevalence of colonic diverticulosisby, showed that the diverticulitis group revealed a statistically significant decreased rate of advanced colonic neoplastic lesion in nearly all age categories and all age-stratified analyses (corresponding OR 0.13-0.43)(27).
3. Obesity
There is an association between diverticular disease and obesity exists, there is no evidence suggesting that obese patients should be managed any differently from the non-obese(28).
4. Bacteremia
There is a report of two cases of bacteraemia with the anaerobic bacterium Ruminococcus gnavus. In both cases the bacteraemia was associated with diverticular disease. Preliminary conventional identification suggested peptostreptococci and MALDI-TOF analysis did not produce scores high enough for species identification. Finally the bacteria were identified with 16S rRNA gene sequencing(29).
5. Segmental colitis
Diverticular disease-associated segmental colitis is a unique variant of chronic colitis limited to segments of the left colon that harbor diverticula, according to the study by the University of Arkansas for Medical Sciences(30).
6. Etc.
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