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Clinical Gastroenterology and... Aug 2020The prevalence of diverticulosis differs with demographic features of patients, but evidence is limited. Well-defined demographic studies are necessary to understand...
BACKGROUND & AIMS
The prevalence of diverticulosis differs with demographic features of patients, but evidence is limited. Well-defined demographic studies are necessary to understand diverticulosis biology. We estimated the prevalence of diverticulosis among patients of different ages, sexes, and races and ethnicities and calculated odds ratios.
DESIGN
Using data from an endoscopic database, we identified 271,181 colonoscopy procedures performed from 2000 through 2012 at 107 sites in the United States. Our analysis included individuals 40 years and older who underwent colonoscopy examination for average-risk screening. The outcome was any reported diverticulosis on colonoscopy. Multivariate analyses were performed using logistic regression to estimate odds ratios (ORs) and 95% CI values, adjusting for confounding variables.
RESULTS
The prevalence of diverticulosis increased with age in men and women of all races and ethnicities. Women 40-49 years old had significantly lower odds of any diverticulosis (OR, 0.71; 95% CI, 0.63-0.80) compared with men 40-49 years old, after adjustment. The strength of this association decreased with age. Compared with non-Hispanic white individuals, non-Hispanic black individuals (OR, 0.80; 95% CI, 0.77-0.83) and Asian/Pacific Islanders (OR, 0.38; 95% CI, 0.35-0.41) had lower odds of any diverticulosis. However, non-Hispanic black individuals (OR, 1.53, 95% CI, 1.44-1.62) had increased odds of any proximal diverticulosis, whereas Asian/Pacific Islanders (OR, 3.12; 95% CI, 2.67-3.66) had increased odds of only proximal diverticulosis.
CONCLUSIONS
In an analysis of data from 271,181 colonoscopy procedures, diverticulosis was less prevalent in women compared with men in the same age groups, indicating that sex hormones might affect pathogenesis. Differences in the odds of diverticulosis by race and ethnicity indicate a genetic contribution to risk.
Topics: Adult; Colonoscopy; Diverticulum; Ethnicity; Female; Humans; Logistic Models; Male; Middle Aged; Prevalence; Risk Factors; United States
PubMed: 31634580
DOI: 10.1016/j.cgh.2019.10.022 -
The Korean Journal of Internal Medicine Jan 2020
Topics: Diverticulum; Humans; Tomography, X-Ray Computed
PubMed: 30099863
DOI: 10.3904/kjim.2018.219 -
Folia Medica Cracoviensia Dec 2022Hutch Diverticulum (HD) is defined as the protrusion of the mucosal and submucosal layer through the muscle bundles of the underlying detrusor muscle. HD is located at... (Review)
Review
Hutch Diverticulum (HD) is defined as the protrusion of the mucosal and submucosal layer through the muscle bundles of the underlying detrusor muscle. HD is located at the vesicoureteral junction with a backward direction from the homolateral ureteral orifice. As far as its etiology is concerned, HD is caused either by a congenital muscle wall defect at the level where the Waldeyer's fascia occupies the clefts between the vesical part of the homolateral ureter and the detrusor, or is associated with abortive ureteral duplication or defective incorporation of mesonephric duct into the bladder at the site of ureteral hiatus or finally is associated with the development of transient urethral obstruction. HD is usually unilateral and more common in male patients. It may be associated with the Ehlers-Danlos, Williams-Elfin and Menkes syndromes. HD usually occurs in childhood and rarely during adulthood. It is found in 0.2-13% of all children presenting with urinary tract infection. Through this short review article, we attempt to present in detail the most recent bibliographic data concerning this entity, focusing on pathophysiology, diagnostic approach, and treatment strategy.
Topics: Child; Humans; Male; Adult; Urinary Bladder; Fascia; Diverticulum
PubMed: 36854087
DOI: 10.24425/fmc.2022.144083 -
Balkan Medical Journal Apr 2020
Topics: Child, Preschool; Female; Humans; Intestinal Obstruction; Meckel Diverticulum
PubMed: 31937023
DOI: 10.4274/balkanmedj.galenos.2020.2019.11.23 -
The Canadian Veterinary Journal = La... Nov 2020Spinal subarachnoid diverticula are fluid dilations of the subarachnoid space that can cause a compressive myelopathy in dogs. These diverticula are usually associated... (Review)
Review
Spinal subarachnoid diverticula are fluid dilations of the subarachnoid space that can cause a compressive myelopathy in dogs. These diverticula are usually associated with high motion areas in the cervical and caudal thoracic spine. The definitive etiopathogenesis has not been determined but likely involves congenital or acquired causes. Pugs, French bulldogs, and Rottweilers are overrepresented breeds. Clinical signs typically include ataxia, paresis, and upper motor neuron urinary and/or fecal incontinence; pain is a less common feature. Diagnosis is based on advanced imaging, with magnetic resonance imaging now being favored given the additional detail of the spinal cord parenchyma that can be obtained. Outcomes are better with surgical intervention than with medical therapies, though there is a lack of long-term data. No superior surgical technique has been identified, and questions remain on the significance of addressing leptomeningeal adhesions at the time of surgery. Clinical signs can recur, though not always due to recurrence of diverticulum formation, and pugs may be less likely to have a successful long-term outcome.
Topics: Animals; Diverticulum; Dog Diseases; Dogs; Magnetic Resonance Imaging; Retrospective Studies; Spinal Cord Compression
PubMed: 33149353
DOI: No ID Found -
Annals of Coloproctology Aug 2021Diverticulosis of the colon is a common condition in Western countries and most patients will remain asymptomatic, but some will present with symptoms of acute... (Review)
Review
Diverticulosis of the colon is a common condition in Western countries and most patients will remain asymptomatic, but some will present with symptoms of acute diverticulitis or bleeding. Our understanding of diverticulosis is evolving but is mostly derived from diverticulosis affecting the left-sided colon. In contrast, right-sided colonic diverticulosis (RCD) is more commonly seen in Asian countries but is much less common overall. Based on the marked differences in epidemiology, it is commonly thought that these are 2 distinct disease processes. A review of the literature describing the epidemiology and etiology of RCD was performed, with a comparison to the current understanding of left-sided diverticulosis. RCD is becoming increasingly common. The epidemiology of RCD shows it to be a mostly acquired condition, and not congenital as previously thought. Many factors in the etiology of RCD are similar to that seen in left-sided diverticulosis, with a few variations. It is therefore likely that most cases of RCD represent the same disease process that is seen in the left colon.
PubMed: 34284562
DOI: 10.3393/ac.2021.00192.0027 -
Medicina (Kaunas, Lithuania) Nov 2023Diverticulosis is frequently accompanied by altered bowel habits. The biogenic amines within colonic mucosa control bowel motility, and in particular, alterations in...
Diverticulosis is frequently accompanied by altered bowel habits. The biogenic amines within colonic mucosa control bowel motility, and in particular, alterations in serotonin signaling may play a role in colon diverticulosis. The aim of the study was to assess the concentration of biogenic amines and serotonin receptor expression in the colonic mucosa in patients with diverticulosis and healthy controls. This prospective, comparative study included 59 individuals: 35 with sigmoid diverticulosis and 24 healthy controls. The study was held at the Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, Poland. Mucosal samples were taken from the right and left colon during a colonoscopy in all patients. Concentrations of norepinephrine, 3-methoxy-4-hydroxyphenylglycol, dopamine, homovanillic acid, serotonin, and 5hydroxyindoleacetic acid were measured with high-performance liquid chromatography. Expressions of human 5-hydroxytryptamine receptor 3A, 5-hydroxytryptamine receptor 4, 5-hydroxytryptamine receptor 7, solute carrier family 6 member 4 (SERT) for serotonin, as well as the neuroglia activation markers glial fibrillary acidic protein, S100 calcium-binding protein B, and proteolipid protein 1, were assessed with polymerase chain reaction. The median age and sex distribution were comparable in both study groups (median 69 y vs. 52 y; < 0.455 and males/females in cases 11/17 vs. 18/19 in controls; < 0.309). In diverticulosis patients, there was a higher concentration of serotonin in the left affected colon compared to the right healthy part of the colon (median 8239 pg/mg vs. 6326 pg/mL; < 0.01). The expression was lower in the affected left segment compared to the right colon (median 0.88 vs. 1.36; < 0.01). There was a higher colonic mucosa concentration of serotonin (median 8239 pg/mg vs. 6000 pg/mL; < 0.02) and 5hydroxyindoleacetic acid/serotonin ratio (median 0.27 vs. 0.47; < 0.01) in diverticulosis patients compared to controls in the left side of the colon. The concentration of serotonin in the mucosa of the colon segment affected by diverticula is higher than in the healthy segment in the same individuals and higher than in healthy controls. These results underline serotonin signaling in colon diverticulosis pathophysiology.
Topics: Humans; Male; Female; Serotonin; Prospective Studies; Hydroxyindoleacetic Acid; Colon; Receptors, Serotonin; Diverticulum
PubMed: 38003994
DOI: 10.3390/medicina59111945 -
Digestion 2020In both Western countries and in Japan, the incidence of colonic diverticular bleeding has increased with increased use of antithrombotic and nonsteroidal... (Review)
Review
BACKGROUND
In both Western countries and in Japan, the incidence of colonic diverticular bleeding has increased with increased use of antithrombotic and nonsteroidal anti-inflammatory drugs (NSAIDs). Therefore, the Japan Gastroenterological Association issued guidelines for colonic diverticular bleeding and colonic diverticulitis in Japanese in 2017 and in English in 2019. However, the guidelines contain unresolved problems. Herein, we review the recent treatment trends for colonic diverticular bleeding in Japan.
SUMMARY
Colonic diverticular bleeding necessitates frequent blood transfusions due to rebleeding, and patients require prolonged hospitalization. Endoscopic treatment plays an important role in treating diverticular bleeding. Currently, endoscopic band ligation (EBL) and endoscopic clipping are used in Japan for diverticular hemorrhage when the source of the hemorrhage is identified. EBL results in significantly lower early (<30 days) and 1-year rebleeding rates and long-term recurrence rates compared with endoscopic clipping. Furthermore, the proportion of patients requiring transcatheter arterial embolization or surgery after EBL is significantly lower than that following endoscopic clipping. Several reports state that EBL is superior to endoscopic clipping; however, EBL has associated complications, and it is necessary to carefully consider the individual patient. Key Messages: EBL is superior to endoscopic clipping regarding short- and long-term rebleeding rates and the rate of transition to surgery and embolization. Methods for preventing diverticular hemorrhage have not been established, but NSAIDs should be discontinued if possible. Prevention strategies for diverticular bleeding need to be evaluated in studies with large sample sizes.
Topics: Colonoscopy; Diverticulum, Colon; Embolization, Therapeutic; Gastrointestinal Hemorrhage; Hemostasis, Endoscopic; Humans; Japan; Ligation; Surgical Instruments; Surgical Stapling
PubMed: 31722336
DOI: 10.1159/000504089 -
Acta Medica Academica Dec 2022The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel's Diverticulum. (Review)
Review
OBJECTIVE
The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel's Diverticulum.
METHODS
A narrative review of the literature was undertaken by means of the PubMed database, using the terms: "Meckel's Diverticulum AND vessels", "Meckel's Diverticulum AND anatomical variation" and "Meckel's Diverticulum variation". Classical anatomical textbooks were also used for normal anatomy. Additional articles provided useful information in relation to the aim of this review. Hence, the articles that met the inclusion criteria were included in this review, and the collected data were categorized into a single table.
RESULTS
The majority of studies indicated the presence of an abnormal vitelline artery. Other angiographic findings concerned variations of the ileal and the iliac arteries. However, the literature revealed the presence of vascular variations without the existence of Meckel's Diverticulum, whereas a remnant of the vitelline vein may be present, but it is very rare.
CONCLUSION
The detection of vascular variations accompanying Meckel's Diverticulum is not always easy and requires the correct choice of imaging method to prevent misdiagnosis.
Topics: Humans; Meckel Diverticulum; Ileum; Angiography; Arteries; Veins
PubMed: 36799317
DOI: 10.5644/ama2006-124.394 -
The Journal of Craniofacial Surgery Oct 2023Pharyngoesophageal diverticula are rare causes of dysphagia. Zenker's diverticulum is the most common type, followed by Killian-Jamieson diverticulum. A 44-year-old male...
Pharyngoesophageal diverticula are rare causes of dysphagia. Zenker's diverticulum is the most common type, followed by Killian-Jamieson diverticulum. A 44-year-old male presented to our clinic with a longstanding history of dysphagia and globus sensation. Bilateral pharyngoesophageal diverticula were confirmed by imaging CT and esophagogastroscopy. He underwent transcervical resection, and a right Killian-Jamieson diverticulum was observed during surgery. The left diverticulum was found to originate above the cricopharyngeus muscle and was labeled as Zenker's diverticulum. Bilateral pharyngoesophageal diverticula are rare, and physicians should be aware of the variable clinical presentations and management options for pharyngoesophageal diverticula.
Topics: Male; Humans; Adult; Zenker Diverticulum; Deglutition Disorders; Diverticulum; Physicians
PubMed: 37357348
DOI: 10.1097/SCS.0000000000009434