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Journal of the American College of... Nov 2023The etiology of diverticulitis is multifactorial and poorly understood. We estimated the familiality of diverticulitis using the Utah Population Database, a statewide...
BACKGROUND
The etiology of diverticulitis is multifactorial and poorly understood. We estimated the familiality of diverticulitis using the Utah Population Database, a statewide database linking medical records with genealogy data.
STUDY DESIGN
We identified patients with diverticulitis diagnosed between 1998 and 2018 and age- and sex-matched controls in the Utah Population Database. Risk of diverticulitis in family members of patients and controls was calculated using multivariable Poisson models. We performed exploratory analyses to determine the association of familial diverticulitis with severity of disease and age of onset.
RESULTS
The study population included 9,563 diverticulitis patients (with 229,647 relatives) and 10,588 controls (with 265,693 relatives). Relatives of patients were more likely to develop diverticulitis (incidence rate ratio [IRR] 1.5, 95% CI 1.4 to 1.6) compared with relatives of controls. There was an elevated risk of diverticulitis among first-degree (IRR 2.6, 95% CI 2.3 to 3.0), second-degree (IRR 1.5, 95% CI 1.3 to 1.6), and third-degree relatives of patients (IRR 1.3, 95% CI 1.2 to 1.4). Complicated diverticulitis was more common among relatives of patients compared with relatives of controls (IRR 1.6, 95% CI 1.4 to 1.8). Age at diverticulitis diagnosis was similar between groups (relatives of patients 0.2 years older than relatives of controls, 95% CI -0.5 to 0.9).
CONCLUSIONS
Our results indicate that the first-, second-, and third-degree relatives of diverticulitis patients are at elevated risk of developing diverticulitis. This information may aid surgeons in counseling patients and family members about diverticulitis risk and can inform the development of future risk-stratification tools. Further work is needed to clarify the causal role and relative contribution of various genetic, lifestyle, and environmental factors in the development of diverticulitis.
Topics: Humans; Infant; Case-Control Studies; Family; Incidence; Diverticulitis; Utah; Risk Factors; Genetic Predisposition to Disease
PubMed: 37403933
DOI: 10.1097/XCS.0000000000000799 -
Inflammatory Bowel Diseases Aug 2022
Topics: Colitis; Colitis, Ulcerative; Diverticulitis; Humans; Inflammatory Bowel Diseases
PubMed: 35460402
DOI: 10.1093/ibd/izac057 -
Gastroenterology Nov 2022
Topics: Humans; Megacolon; Diverticulitis, Colonic
PubMed: 35667409
DOI: 10.1053/j.gastro.2022.06.004 -
Minerva Gastroenterology Jun 2023
Topics: Humans; Diverticulitis; Diverticulitis, Colonic; Antibodies, Monoclonal, Humanized
PubMed: 33978389
DOI: 10.23736/S2724-5985.21.02894-1 -
American Family Physician Aug 2022Diverticulitis should be suspected in patients with isolated left lower quadrant pain, abdominal distention or rigidity, fever, and leukocytosis. Initial laboratory...
Diverticulitis should be suspected in patients with isolated left lower quadrant pain, abdominal distention or rigidity, fever, and leukocytosis. Initial laboratory workup includes a complete blood count, basic metabolic panel, urinalysis, and C-reactive protein measurement. Computed tomography with intravenous contrast is the preferred imaging modality, if needed to confirm diagnosis and assess for complications of diverticulitis. Treatment decisions are based on the categorization of disease as complicated vs. uncomplicated. Selected patients with uncomplicated diverticulitis may be treated without antibiotics. Complicated diverticulitis is treated in the hospital with modified diet or bowel rest, antibiotics, and pain control. Abscesses that are 3 cm or larger should be treated with percutaneous drainage. Emergent surgery is reserved for when percutaneous drainage fails or the patient's clinical condition worsens despite adequate therapy. Colonoscopy should not be performed during the flare-up, but should be considered six weeks after resolution of symptoms in patients with complicated diverticulitis who have not had a high-quality colonoscopy in the past year. Diverticulitis prevention measures include consuming a vegetarian diet or high-quality diet (high in fruits, vegetables, whole grains, and legumes), limiting red meat and sweets, achieving or maintaining a body mass index of 18 to 25 kg per m2, being physically active, and avoiding tobacco and long-term nonsteroidal anti-inflammatory drugs. Partial colectomy is not routinely recommended for diverticulitis prevention and should be reserved for patients with more than three recurrences or abscess formation requiring percutaneous drainage.
Topics: Anti-Bacterial Agents; Colectomy; Diverticular Diseases; Diverticulitis; Diverticulitis, Colonic; Humans
PubMed: 35977135
DOI: No ID Found -
The Surgical Clinics of North America Dec 2021Diverticulosis of the sigmoid colon is common in the developed world, affecting approximately 33% of persons older than 60 years. Up to 15% of these patients will... (Review)
Review
Diverticulosis of the sigmoid colon is common in the developed world, affecting approximately 33% of persons older than 60 years. Up to 15% of these patients will develop diverticulitis at some point in their lifetime. The incidence of diverticulitis has increased in the last decade, accounting for nearly 300,000 US hospital admissions and $1.8 billion in annual direct medical costs. With such a wide prevalence and diverse spectrum of clinical presentation, there are bound to be multiple controversies regarding disease management. This article will serve to educate the reader on several important areas to consider when treating this ubiquitous disease.
Topics: Colon, Sigmoid; Diverticulitis, Colonic; Humans
PubMed: 34774275
DOI: 10.1016/j.suc.2021.05.024 -
RoFo : Fortschritte Auf Dem Gebiete Der... Sep 2020
Topics: Abdomen, Acute; Aged; Anastomosis, Surgical; Diagnosis, Differential; Diverticulitis; Diverticulum; Humans; Ileus; Intestinal Perforation; Intestine, Small; Jejunal Diseases; Jejunum; Laparotomy; Male; Peritonitis; Tomography, X-Ray Computed
PubMed: 32674196
DOI: 10.1055/a-1157-9506 -
Medicina (Kaunas, Lithuania) Aug 2021The microbiota is the set of commensal microorganisms, residing in the organism, helping proper functioning of organs and systems. The role that the microbiota plays in... (Review)
Review
The microbiota is the set of commensal microorganisms, residing in the organism, helping proper functioning of organs and systems. The role that the microbiota plays in maintaining the health of vertebrates is widely accepted, particularly in the gastrointestinal system, where it is fundamental for immunity, development, and conversion of nutrients. Dysbiosis is an alteration of the microbiota which refers to a disturbed balance, which can cause a number of pathologies. Probiotics have proven to be effective in modulating the microbiota of the gastrointestinal system and, therefore, in promoting the health of the individual. In particular, Lactobacilli are a group of Gram-positive bacteria, which are able to produce lactic acid through glucose metabolism. They are present in different microenvironments, ranging from the vagina, to the mouth, to different tracts of the small intestine. In the present review, we will discuss the use of in human health in general and more specifically in diverticulitis. In particular we analyze the role of and its anti-inflammatory action. For this review, articles were identified using the electronic PubMed database through a comprehensive search, conducted by combining key terms such as "diverticulitis", "", "human health and disease", "probiotics". We selected all the articles published in the last 10 years and screened 1017 papers. Articles referenced in the screened papers were evaluated if considered interesting for our topic. Probiotics have proven to be effective in modulating the microbiota of the gastrointestinal system and, therefore, in promoting the health of the individual. The importance of probiotics in treating diverticular disease and acute diverticulitis can be further understood if taking into consideration some pathophysiological aspects, associated to the microbiota. plays an important role in human health and disease. The effectiveness of in stimulating a correct bowl motility partly explains its effectiveness in treating diverticulitis. The most important action of is probably its immunomodulating activity. Levels of IL-6, IL-8, and Tumor necrosis factor (TNF-alpha) are reduced after supplementation with different strands of Lactobacilli, while T-regulatory cells increase in number and activity. Anyway, new mechanisms of action of probiotics come to light from the many investigations currently taking place in numerous centres around the world and to improve how exactly probiotic administration could make the difference in the management of diverticular disease and acute diverticulitis.
Topics: Animals; Diverticulitis; Dysbiosis; Female; Humans; Limosilactobacillus reuteri; Microbiota; Probiotics
PubMed: 34441008
DOI: 10.3390/medicina57080802 -
American Family Physician Dec 2020Learn more about the benefits and harms of antibiotics for uncomplicated diverticulitis. (Review)
Review
Learn more about the benefits and harms of antibiotics for uncomplicated diverticulitis.
Topics: Acute Disease; Anti-Bacterial Agents; Diverticulitis; Drug Administration Schedule; Female; Humans; Male; Watchful Waiting
PubMed: 33252904
DOI: No ID Found -
Clinical Imaging Jan 2022Diverticulosis of the colon is a gradually progressive disease that usually starts in early adulthood and increases with advancing age in its anatomical extent and the... (Review)
Review
Diverticulosis of the colon is a gradually progressive disease that usually starts in early adulthood and increases with advancing age in its anatomical extent and the size of diverticula. It is important to recognize the initial stages of diverticular development in young patients in order to properly diagnose and manage the potential complications of this very common intestinal disorder. This article presents the pathological and radiological features of early diverticular formation, when the mucosal outpouchings are very small and contained within the colonic wall as distinct intramural lesions. The subsequent development of intramural diverticulitis and the spectrum of its manifestations on barium enema examination or Computed tomography (CT) are illustrated.
Topics: Adult; Colon; Diverticulitis; Diverticulum; Humans; Radiography; Tomography, X-Ray Computed
PubMed: 34743065
DOI: 10.1016/j.clinimag.2021.10.006