Materiały źródłowe

• #1 Epidemiology, Pathophysiology, and Treatment of Diverticulitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6716971/

  Diverticulitis is a prevalent gastrointestinal disorder that is associated with significant morbidity and health care costs. Approximately 20% of patients with incident diverticulitis have at least 1 recurrence. The lifetime risk of diverticulitis in a person with diverticulosis was reported to range from 10% to 25%. However, modern estimates based on colonoscopy and computed tomography (CT) indicate that fewer than 5% of individuals with diverticulosis develop diverticulitis. Nonetheless, because more than 50% of Americans older than 60 years of age have diverticulosis, diverticulitis is highly prevalent. Annually, in the United States (US), there are more than 2.7 million outpatient visits and 200,000 inpatient admissions for diverticulitis at a cost of more than $2 billion. The incidence of diverticulitis has increased over time and increases with patient age. However, the relative increase in diverticulitis in recent decades has been greatest in young patients. For example, from 1980 through 2007, the incidence of diverticulitis in individuals 40-49 years old increased by 132%.

• #2 Epidemiology and Pathophysiology of Diverticular Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6014835/

  Colonic diverticular disease is a common health care issue which has historically been attributed to western countries and older age population. Recent studies have shown a rise in incidence among developing countries that have adopted western diets as well as rise in prevalence among younger patients. […] Approximately 130,000 hospitalizations occurring every year in the United States are attributable to diverticular disease. […] An analysis of the age-adjusted hospitalization rate of diverticulitis in the United States showed an increase from 62 per 100,000 in 1998 to 76 per 100,000 in 2005. […] The prevalence of diverticular disease is similar between men and women. However, it increases significantly with age, ranging from 10% in those younger than 40 years up to 50 to 70% in those older than 80 years.

• #3 Diverticulitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/173388-overview

  Acute diverticulitis is the third most common inpatient gastrointestinal diagnosis in the United States, at an annual cost of $2.1 billion, and it is the most frequently listed gastrointestinal diagnosis in outpatient clinics and the emergency department. The prevalence of diverticulosis has been shown to be age dependent and ranges from less than 20% at age 40 years to 60% by age 60 years. The prevalence of diverticulitis has been rising over the past several decades, affecting an estimated 180/100,000 persons per year. Previously, it was believed that around 15%-20% of patients with diverticulosis would develop diverticulitis; however, more recent findings have shown the numbers to be closer to 1%-4%. Of those with incident disease, approximately 20% have one or more recurrent episodes within 10 years. Diverticulitis is also a leading indication for elective colectomy. This condition affects patients’ quality of life beyond the period of acute illness.

• #4 Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

  https://www.wjgnet.com/1007-9327/full/v17/i12/1600.htm

  Using the nationwide inpatient sample (NIS), we sought to ascertain nationwide trends in hospitalizations for diverticulitis particularly among cases of younger onset and to evaluate for geographic variations in hospitalization rates within the US. […] The age-adjusted hospitalization rate for diverticulitis increased from 61.8 per 100000 to 75.5 per 100000 between 1998 and 2005, and increased similarly in both sexes. […] Diverticulitis-associated admissions were male-predominant in those younger than age 45 years but were female-predominant thereafter. […] By 2005, the majority of hospitalized patients were 65 years. […] Age-adjusted rates of diverticulitis-associated hospitalizations were lower in the West (50.4/100000) compared to the Northeast (77.7/100000), South (73.9/100000), and Midwest (71.0/100000).

• #5 Diverticular Disease: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/diverticular-disease.html

  Incidence of diverticulitis is increasing. From 1980 to 2007, the incidence increased from 115 per 100,000 person-years to 188 per 100,000 person-years. […] Prevalence of diverticular disease is less than 10% in people 40 years vs. 80% in those older than 85 years. Only 1% to 4% of patients with diverticular disease will develop diverticulitis in their lifetime. Risk factors for diverticular disease include increasing age, constipation, low-fiber diet, smoking, red meat consumption, obesity, weight gain, lack of exercise, genetic susceptibility, and nonsteroidal anti-inflammatory drug and aspirin use. […] Consumption of popcorn, nuts, and seeds is not a risk factor for developing diverticulitis.

• #6 Diverticulitis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/diverticulitis/

  Diverticulitis is a diverticular disease caused by inflammation of colonic diverticula and occurs as a complication of diverticulosis, more commonly in older adults. […] Epidemiological data refers to the US, unless otherwise specified. […] Incidence 188/100,000 person-years. […] Increases with age. […] Occurs in 420% of individuals with diverticulosis. […] Disease burden accounts for 165,000 annual hospital admissions in the US. […] Likelihood of requiring surgery: 15%. […] Mortality: 1%.

• #7 Epidemiology and Pathophysiology of Diverticular Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6014835/

  Although it is well documented that prevalence of diverticulosis increases with age, multiple studies in the past decade have been looking at incidence and disease progression in younger patients who present with diverticulitis. […] The results of the study showed an overall 26% increase in admission for diverticulitis from the year 1998 to 2005. The rates of admission increased more rapidly in patients aged 18 to 44 years compared with older patients (82 vs. 36%, respectively). […] Diverticular disease remains one of the most common diseases of the gastrointestinal tract in western countries and is showing an increasing incidence in younger patients as well as developing countries that have started adopting western diets.

• #8 Diagnosis and Management of Acute Diverticulitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0501/p612.html

  Diverticulosis, defined as the presence of diverticula in the absence of inflammation, occurs in 5 to 10 percent of persons older than 45 years and approximately 80 percent of those older than 85 years.1 In 1998, there were 2.2 million cases of acute diverticulitis in the United States, resulting in $2.4 billion in health care expenditures and approximately 3,400 deaths.3 From 1998 to 2005, the annual age-adjusted admissions for diverticulitis increased by 26 percent, with the greatest increased rates of admissions occurring in persons 18 to 44 years of age (82 percent) and 45 to 74 years of age (36 percent).4 In the United States, there is an increased incidence of admissions for acute diverticulitis in the summer months compared with other months, regardless of age, sex, race, or geographic region.5 Of those who have diverticulosis, the lifetime prevalence of developing acute diverticulitis is approximately 25 percent.6

• #9 Epidemiology, Pathophysiology, and Treatment of Diverticulitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6716971/

  Diverticulitis is more common in men than women until the 6th decade, when it becomes more common in women. The prevalence of hospitalization for diverticulitis in the US is greatest in whites (62/100,000), similar in African Americans and Hispanics (approximately 30/100,000), and lowest in Asians (10/100,000). Individuals living in urban areas are more likely to be hospitalized for diverticulitis than those in rural areas, as are those with lower income and educational levels. Diverticulitis is more common in developed countries, but could be increasing in other parts of the world. After immigration, non-Western individuals have a lower risk of hospitalization for diverticular disease than Western natives, although risk increases with time since immigration. […] The most common complication is phlegmon or abscess (approximately 70% of patients with complications) followed by peritonitis, obstruction, and fistula. Mortality following complicated diverticulitis (diverticulitis with phlegmon, abscess, perforation or fistula) is increased compared to uncomplicated diverticulitis, and is highest among individuals with perforation or abscess. An estimated 8% of patients with incident disease have recurrences within the first year after complete recovery from the incident episode, and 20% have recurrences within 10 years. The risk of recurrence increases with subsequent episodes. After a second episode, the risk is 18% at 1 year and 55% at 10 years, and after a third episode it is 40% at 3 years.

• #10 Diverticulitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/173388-overview

  Diverticular disease occurs more frequently in Western countries but continues to increase worldwide. Why diverticular disease is less common in underdeveloped countries is unclear, but it is presumably secondary to lifestyle and dietary factors. For example, the prevalence of diverticulosis increased in Japan after its population adopted a more Western lifestyle. Diverticulitis involving the left colon typically affects false diverticula, which are also usually found in Western populations. Right-sided and cecal diverticulitis (involving true diverticula) are more prevalent in the Asian population, accounting for up to 75% of cases of diverticulitis in this group. […] The incidence of diverticular disease increases with age (65% in those 85 years). Most patients with diverticulitis are older than 50 years; the mean age at presentation appears to be about 60 years. However, diverticulitis is increasingly being seen in younger persons. Although a male preponderance was noted in early series, subsequent studies have suggested either an equal sex distribution or a female preponderance. In those younger than 50 years, diverticulitis is more common in men; a slight female preponderance exists between the ages of 50 and 70 years, and there is a marked female preponderance in those older than 70 years.

• #11 English | World Gastroenterology Organisation

  https://www.worldgastroenterology.org/guidelines/diverticular-disease/diverticular-disease-english

  Prevalence by age [1]: […] Age 40: 5% […] Age 60: 30% […] Age 80: 65% […] Prevalence by sex: […] Age 50: more common in males […] Age 50-70: slight preponderance in women […] Age 70: more common in women […] Diverticular disease is far more frequent in older people, with only 25% of cases occurring in those under 40 years of age. In this younger age group, diverticular disease occurs more frequently in males, with obesity being a major risk factor (present in 84-96% of cases) [2,3]. The diverticula are usually located in the sigmoid and/or descending colon. […] The natural history still shows a trend towards recurrent symptoms [4] and an increased incidence of poor outcomes ultimately requiring surgery [5]. […] Diverticulosis is symptomatic in 70% of cases; leads to diverticulitis in 15-25%; and is associated with bleeding in 5-15% [1].

• #12 Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

  https://www.wjgnet.com/1007-9327/full/v17/i12/1600.htm

  Diverticulitis-associated hospitalizations have steeply risen, especially in young adults. […] These epidemiological trends vary by geographic region and warrant further investigation into potential dietary and environmental etiologies. […] The overall age-adjusted hospitalization rate for diverticulitis increased from 61.8 per 100000 to 75.5 per 100000 during the study period. […] There was significant geographic variation in overall and age-specific growth rate of hospitalizations for acute diverticulitis. […] The overall age-adjusted rates of diverticulitis-related hospitalizations were 77.7 per 100000 for the Northeast, 71.0 per 100000 for the Midwest, 73.9 per 100000 for the South, and 50.4 per 100000 for the West. […] The sharpest increases were observed in the Northeast (64.8 to 90.2 per 100000; overall 39%) and the Midwest (60.5 to 74.8 per 100000; overall 33%).

• #13

  https://bpac.org.nz/2023/diverticulitis.aspx

  Few people with diverticulosis develop diverticulitis. […] Approximately 4% of people with diverticulosis will develop diverticulitis. […] The epidemiological distribution of diverticulitis is changing. […] In New Zealand, the age at which patients are hospitalised with diverticulitis differs by ethnicity; Mori (56.2 years), Pacific peoples (58.4 years) and people of Asian ethnicity (58.9 years) develop diverticular disease and present to hospital at a younger age than New Zealand Europeans (65.8 years). […] Although diverticulitis is more likely to be diagnosed in older people, younger males are being hospitalised with diverticular disease at far higher rates than previously reported. […] Only a small number of people with diverticulosis will progress to diverticulitis, estimated to be around 4%, and in most people this will occur at an older age.

• #14 Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and pathogenesis – UpToDate

  https://www.uptodate.com/contents/colonic-diverticulosis-and-diverticular-disease-epidemiology-risk-factors-and-pathogenesis

  Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and pathogenesis […] Diverticular disease of the colon is an important cause of hospital admissions and a significant contributor to health care costs in Western and industrialized societies. […] This topic will review the epidemiology, risk factors, and the pathogenesis of diverticulosis and diverticular disease. […] Epidemiology […] Prevalence — The prevalence of diverticulosis is age-dependent, and the prevalence and distribution within the colon varies by geography and race. In the United States, the prevalence of diverticulosis increases from fewer than 20 percent at age 40 to 60 percent by age 60. The number and size of diverticula also increase with age, suggesting that diverticulosis is a progressive process. The prevalence of diverticulosis appears to be higher in the left colon in countries in the West. In a study of 624 individuals undergoing first-time screening colonoscopy of whom 260 (42 percent) had diverticulosis, 72 percent had diverticula in the sigmoid colon, 10 percent in the descending, 6 percent in the transverse, 11 percent in the ascending, and 1 percent in the cecum. Black Americans were more likely to have diverticula in the proximal colon than White Americans. Data from more than 270,000 colonoscopy procedures indicate that females are less likely to have diverticulosis than males, particularly in younger age groups. Non-Hispanic White Americans were more likely to have diverticulosis than non-Hispanic Black Americans and Asian/Pacific Islanders. Non-Hispanic Black Americans were at increased odds of having any proximal diverticulosis and Asian/Pacific Islanders were at increased odds of having only proximal diverticulosis, which are often congenital in nature.

• #15 Clinical manifestations and diagnosis of acute colonic diverticulitis in adults – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-acute-colonic-diverticulitis-in-adults

  Colonic diverticulosis is a common finding on colonoscopy. The prevalence of diverticulosis increases with age. More than 70 percent of adults 80 years and older have diverticulosis on colonoscopy. Only 1 to 4 percent of patients with colonic diverticulosis will develop acute diverticulitis over seven years of follow-up. […] The epidemiology of diverticulosis, diverticular disease, and diverticular bleeding and the management of acute diverticulitis and diverticular bleeding are discussed in detail, separately.

• #16 Epidemiology, Pathophysiology, and Treatment of Diverticulitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6716971/

  Diverticulitis was once thought to be a progressive disease with an increasing risk of complications as the number of episodes increased. However, complications, with the exception of fistula formation, occur more commonly during the first episode of diverticulitis than after subsequent episodes. Population-based data also indicate that the risk of recurrence after complicated diverticulitis treated medically is similar to the risk following uncomplicated diverticulitis. […] Modern studies have confirmed and expanded the role of diet and other modifiable lifestyle factors in the natural history of diverticulitis. Lifestyle factors associated with increased risk include Western dietary patterns (high in red meat, fat, and refined grains) and red meat consumption alone. Obesity, and central obesity in particular, increases the risk of diverticulitis. Smoking is also associated with an increased risk of diverticulitis, particularly complicated diverticulitis. On the other hand, dietary fiber intake and prudent diets (high in fruits, vegetables, and whole grains) reduce the risk of diverticulitis.

• #17 Epidemiology, Pathophysiology, and Treatment of Diverticulitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6716971/

  A study examining the joint contribution of multiple lifestyle risk factors on risk of incident diverticulitis found that adherence to a low-risk lifestyle decreased the risk of diverticulitis by nearly 75%. A low-risk lifestyle was defined as fewer than 4 servings of red meat per week, at least 23g of fiber per day, 2 hrs of vigorous activity per week, body mass index 18.5-24.9, and no history of smoking. Assuming causal associations, it was estimated that a low-risk lifestyle could prevent half of diverticulitis cases. […] Several medications have been associated with increased risk of diverticulitis. Prospective cohort and case-control studies have found a consistent positive association between nonsteroidal anti-inflammatory drug (NSAIDs) use and diverticulitis. The association appears to be stronger for non-aspirin NSAIDs than for aspirin. Non-aspirin NSAIDs also appear to be more strongly associated with complicated or perforated diverticulitis than with uncomplicated disease.

• #18 Diverticular Disease: A Crash Course for Clinicians

  https://www.gastroendonews.com/PRN/Article/02-23/Diverticular-Disease-A-Crash-Course-for-Clinicians/69341

  Nonsteroidal anti-inflammatory drugs (NSAIDs) are clearly the most significant risk factor for diverticular bleeding. […] Because of this evidence, Dr. Stollman suggested that elective use of NSAIDsnot including aspirin when it is indicatedbe avoided or minimized in all patients with a history of diverticulitis. […] Another development in the understanding of diverticular disease is the involvement of genetics. […] A novel prospective comparative study from Turkey, where people sometimes squat to defecate rather than sit on Western-type toilets, has concluded that sitting during defecation increases the risk for diverticulosis. […] Dr. Stollman also discussed some considerations for managing patients with acute disease, such as use of antibiotics and other therapies, as well as surgery.

• #19 Diverticulitis – Wikipedia

  https://en.wikipedia.org/wiki/Diverticulitis

  Diverticulitis most often affects the elderly. In Western countries, diverticular disease most commonly involves the sigmoid colon (95 percent of people with diverticulitis). Diverticulosis affects 5–45% of individuals with the prevalence of diverticulosis increasing with age from under 20% of individuals affected at age 40 up to 60% of individuals affected by age 60. […] Left-sided diverticular disease (involving the sigmoid colon) is most common in the West, while right-sided diverticular disease (involving the ascending colon) is more common in Asia and Africa. Among people with diverticulosis, 4–15% may go on to develop diverticulitis.

• #20 The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review

  https://coloproctol.org/DOIx.php?id=10.3393/ac.2021.00192.0027

  Asian countries The overall prevalence of diverticulosis in Asian countries is much lower than that seen in the West; however, RCD predominates. When considered as a proportion of individuals with diverticulosis, the majority have right-sided or bilateral diverticula. Similar to that seen in Western populations, the prevalence of diverticulosis has been increasing in recent years. […] Diverticulosis affecting the right colon is becoming increasingly common. Historical teaching explained RCD as an uncommon congenital finding in Asian populations. Our understanding of this condition has improved, and there is increasing evidence showing it to be an extension of the more common LCD, with a few variations in its etiology. The increasing prevalence of RCD parallels that observed for LCD in recent decades. While the changes in RCD are not entirely explained by the etiological factors discussed above, it is likely the trend will continue. As the prevalence of RCD increases, its clinical manifestations such as AD are likely to be encountered more frequently in the coming decades.

• #21 Epidemiology, Pathophysiology, and Treatment of Diverticulitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6716971/

  Diverticulitis has a considerable impact on patients and the health care systems. Large, prospective cohort studies have identified the importance of diet, lifestyle, medication, and genetic factors in development. Increased understanding of the natural history of diverticulosis and diverticulitis has led to less aggressive management approaches, and findings from studies of inflammation and the intestinal microbiome have stimulated new avenues of research and treatment.

• #22 Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

  https://www.wjgnet.com/1007-9327/full/v17/i12/1600.htm

  Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States. […] The prevalence of diverticular disease increases with age, occurring in less than 10% of those who are younger than 40 years and being as high as 66% in those older than 80 years. […] Between 10%-25% of individuals with colonic diverticula will develop diverticulitis, of which a quarter can develop life threatening complications such as obstruction, perforation and intraperitoneal abscess formation. […] There is significant geographic variation in the prevalence of diverticular disease, occurring much less commonly among Asians compared to western populations. […] Though diverticular disease is generally thought to be a disease of older adults, there are increasingly common reports of diverticulitis in individuals younger than 50 years.

• #23 epidemiology « My Diverticulitis

  http://www.mydiverticulitis.co.uk/content/tag/epidemiology/

  The theory, that diverticular disease (DD) was caused by low levels of fibre in the diet, has been prominent for about 40 years. […] Data from post-mortems, mortality statistics and surveys can provide information on the occurrence of DD, each aspect contributing to the overall picture. […] The results fall into 4 distinct patterns of when DD appeared and how numbers have changed over time until 2010.

• #24 The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review

  https://coloproctol.org/DOIx.php?id=10.3393/ac.2021.00192.0027

  When considering the epidemiology of diverticulosis, 2 features dominate geography and age. The prevalence of RCD varies markedly. As diverticulosis is asymptomatic in the majority, establishing the prevalence in a population remains challenging. The reported prevalence varies not only with the population being studied but also with the modality used for diagnosis. Cross-sectional imaging is generally considered to be more sensitive for the detection of diverticulosis than endoscopy. However, such imaging is mostly performed in patients with abdominal symptoms of some description, resulting in selection bias. In contrast, colonoscopy is commonly used in asymptomatic patients for colorectal cancer screening, resulting in large datasets of asymptomatic patients, from which to estimate the prevalence. A limitation of colonoscopy is the potential for missing diverticula obscured by haustral folds. Perhaps more importantly, since diverticulosis can be such a common finding at colonoscopy, it may be considered normal by the endoscopists and omitted from the procedure report. This may result in underestimation of the true prevalence in large colonoscopy datasets. Regardless of the method of diagnosis, there are clear geographic differences seen in the absolute prevalence of RCD, and what proportion of diverticulosis it comprises.

• #25 Colonic Diverticular Disease | ASCRS Textbook of Colon and Rectal Surgery

  https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285032/all/Colonic_Diverticular_Disease

  The prevalence of diverticula-related illness has risen in the United States over the past few decades. […] A recent report utilizing information from the National Inpatient Sample (NIS) suggested that the rate of hospitalization for diverticulitis increased from 74.1/100,000 in the year 2000 to 96.0/100,000 in 2008. […] In 2010, there were more than 2.7 million discharges in the ambulatory setting associated with a diagnosis of diverticular disease. […] In 2012 there were 340,000 emergency department visits for diverticulitis. […] More recent data revealed that in 2014, there were 1.92 million patients diagnosed with diverticular disease in the ambulatory setting. […] The estimated aggregate national cost of caring for patients with diverticular disease in the emergency setting was $1.6 billion in 2013.

• #26 Diverticulitis Is Associated with Increased Risk of Colon Cancer—A Nationwide Register-Based Cohort Study

  https://www.mdpi.com/2077-0383/13/9/2503

  There are conflicting results in the literature regarding the association between diverticulitis and colon cancer. In a previous study, we found that patients with diverticulitis had an increased risk of colon cancer. However, due to the design of the study, it was not possible to deduce a temporal relationship. Other studies point to the risk being increased in the first year after diverticulitis. However, none of these studies have a long-term follow-up for examining the relationship between the two diseases. […] This study aimed to investigate a temporal relationship between diverticulitis and the subsequent development of colon cancer. We included 29,173 adult males and females with diverticulitis and 145,865 controls matched for sex and age. The incidence proportion of colon cancer was 2.1% in the diverticulitis group and 1.5% in the matched control group (hazard ratio 1.6). The risk of having a colon cancer diagnosis was significantly increased in the first six months after inclusion (hazard ratio 1.7), and hereafter there was a lower risk in the diverticulitis group compared with controls (hazard ratio 0.8). This protective effect lasted eight years. The increased risk of colon cancer during the first six months after diverticulitis was also found in the cohort with prior colonoscopies.

• #27 Diverticulitis Is Associated with Increased Risk of Colon Cancer—A Nationwide Register-Based Cohort Study

  https://www.mdpi.com/2077-0383/13/9/2503

  We found an increased risk of developing colon cancer for patients with diverticulitis compared with controls without diverticulitis. The increase was limited to the first six months after the diagnosis of diverticulitis. After the first six months, there was a decreased risk of colon cancer in the group with diverticulitis until eight years after the diagnosis. The increased risk during the first six months was also identified in the sensitivity analysis of the cohort with colonoscopy up to two years before inclusion. The subgroup analysis showed an increased risk of colon cancer for patients with complicated diverticulitis compared with patients with uncomplicated diverticulitis. […] The international guidelines on patient management after an episode of diverticulitis differ regarding the follow-up colonoscopy. The vast majority of guidelines recommend a follow-up colonoscopy after an episode of diverticulitis, either in all patients, those with complicated diverticulitis, with persisting symptoms, or without a recent colonoscopy. In Denmark, the national guideline recommends a colonoscopy when the acute phase of diverticulitis has passed, which is usually about six to eight weeks after the first admission. Our study was performed using data from comprehensive, national, Danish registers, linked at an individual level and including adults with a hospital admission for diverticulitis. The applicability of our results is high for countries with similar living standards and a similar composition of age and ethnicity to the Danish population. Our results, however, are probably not applicable to countries with a very different incidence or localization of diverticulitis. The results of this study support the continued practice of performing a colonoscopy after an episode of diverticulitis. However, specific recommendations regarding the optimal timing or frequency of colonoscopy examinations cannot be made based on these results.

• #28 Advances in Diverticulitis Treatment and Prevention – Mass General Advances in Motion

  https://advances.massgeneral.org/digestive-health/video.aspx?id=1186

  This, I think, potentially could have a huge impact in terms of preventing patients from developing diverticulitis and ultimately requiring surgery; as such, I think this represents from a population scale, a very real intervention that could have significant public health benefits. […] While we do understand that there is a tremendous amount of work to be done in terms of disease prevention, a lot of medicine at this point is been focused on how do we better treat conditions when people develop them, how do we better deliver therapies. […] Unfortunately, there is not a lot of research being done on disease prevention. There are also very few resources being focused on disease prevention.

• #29 Advances in Diverticulitis Treatment and Prevention – Mass General Advances in Motion

  https://advances.massgeneral.org/digestive-health/video.aspx?id=1186

  Diverticulitis is one of the most common gastrointestinal conditions that patients present with to primary care clinics and to gastroenterologists. […] Unfortunately, there has not been much progress made in how we can prevent diverticulitis. […] So our research has really been focused on trying to use population-scale data to understand what are risk factors for people who develop diverticulitis and how is it that we can modify lifestyle and diet to prevent episodes from occurring. […] For example, we’ve identified that specific types of dietary factors may be linked. […] Our hope is that these research findings can be translated into effective clinical interventions by having doctors actually being able to recommend a patient-specific lifestyle intervention that could reduce the risk of having a flare.

• #30 What Is Diverticulitis? – Consensus: AI Search Engine for Research

  https://consensus.app/home/blog/what-is-diverticulitis/

  Diverticulitis is a common and potentially serious condition that requires a comprehensive understanding of its epidemiology, pathophysiology, clinical presentation, and management strategies. […] Understanding the epidemiology, pathophysiology, risk factors, and management strategies for diverticulitis is crucial for effective treatment and prevention. […] Diverticulitis is a prevalent condition, particularly in developed countries. The prevalence of diverticular disease has been increasing, with significant health and economic burdens. For instance, the prevalence of perforated sigmoid diverticular disease in developed countries rose from 2.4 per 100,000 in 1986 to 3.8 per 100,000 in 2000. In the United States alone, diverticular disease is one of the five most costly gastrointestinal disorders. The incidence of diverticulitis increases with age, affecting up to 50% of people by the fifth decade and 67% by the eighth decade.

• #31 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00313-4

  ALCD is a common problem encountered by Western surgeons in the acute setting. The sigmoid colon is usually the most commonly involved part, while acute right-sided diverticulitis (ARCD) is rarer but much more common in non-Western populations. […] The World Society of Emergency Surgery (WSES) guidelines for management of ALCD were published in 2016. In 2020, the guidelines were revised and updated. […] The present guidelines have been developed according to the GRADE methodology. […] A multidisciplinary panel of experts, coordinated by a central coordinator, was selected to serve as experts in this 2020 update of the WSES guidelines for the management of acute left-sided colonic diverticulitis (ALCD). […] The expert panel states that in very acutely onset disease, CRP values might not have risen yet, since there is a delay of 68h from the onset of the disease, reaching peak at 48h. Therefore, caution should be used in using low CRP as excluding out acute diverticulitis. […] Although studies have shown that the percentage of complications requiring surgery is higher in patients with ALCD than in patients with ARCD, the principles of diagnosis and treatment of patients with ARCD are similar to those with ALCD.

• #32

  https://step2.medbullets.com/evidence/30660732

  Diverticulitis is a prevalent gastrointestinal disorder that is associated with significant morbidity and health care costs. Approximately 20% of patients with incident diverticulitis have at least 1 recurrence. Complications of diverticulitis, such as abdominal sepsis, are less likely to occur with subsequent events. Several risk factors, many of which are modifiable, have been identified including obesity, diet, and physical inactivity. […] Diet and lifestyle factors could affect risk of diverticulitis through their effects on the intestinal microbiome and inflammation. Preliminary studies have found that the composition and function of the gut microbiome differ between individuals with vs without diverticulitis. Genetic factors, as well as alterations in colonic neuromusculature, can also contribute to the development of diverticulitis. […] Despite these advances, more research is needed to increase our understanding of the pathogenesis of diverticulitis and to clarify treatment algorithms.

• #33 Diverticulitis | Acute Diverticulitis in Young Patients: A Review of the Changing Epidemiology and Etiology | springermedicine.com

  https://www.springermedicine.com/diverticulitis/acute-diverticulitis-in-young-patients-a-review-of-the-changing-/21593394

  Acute diverticulitis is one of the leading gastrointestinal causes for hospitalization. The incidence of acute diverticulitis has been increasing in recent years, especially in patients under 50 years old. […] Our understanding of the natural history of this condition has evolved, and current clinical practice guidelines suggest age should not alter management. The purpose of this review is to evaluate the changing epidemiology of acute diverticulitis, consider potential explanations for the observed increased incidence in younger patients, as well as review the natural history of acute diverticulitis in the younger population. […] Diverticular disease epidemiology: Acute hospitalisations are growing fastest in young men. […] Diverticular disease increases and affects younger ages: An epidemiological study of 10-year trends.

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