We performed a long-term follow-up study of patients with segmental colitis associated with diverticula, in order to clarify the natural history of this disease.
We identified 15 patients who were diagnosed as having segmental colitis associated with diverticula during 1997. We assessed these patients by means of periodic follow-up visits from 1997 to 2004.
Eight of the 15 patients had no clinical recurrence during follow-up. Five patients had sporadic recurrences that were clinically mild (on average, one in 5 years), which responded to topical therapy and often to self-medication. Only two patients were diagnosed during the follow-up period as having Crohn's disease; notably, these were the only patients who did not have hematochezia as the main symptom at onset.
The course of this disease appears to be substantially benign.
"Prevalence of diverticulitis has been considered overestimated because most of the subjects who visited referral hospitals for colonoscopy had abdominal symptoms and they had the chance to suffer from complicatied diverticulosis. Between 10 and 25% of the patients with symptomatic uncomplicated diverticular disease suffer from diverticulitis (15, 16). "
[Show abstract][Hide abstract] ABSTRACT: This study was done to evaluate prospectively the clinical significance of colonic diverticulosis. In the 1,030 consecutive outpatients undergoing colonoscopy, the information on the demographics, the patterns of bowel symptoms, and the prevalence of colon polyp were analyzed according to the presence of colonic diverticulosis. The mean age of 1,030 patients were 52.2 yr and 59.3% were male. The prevalence of diverticulosis was 19.7% (203/1,030). Of 203 diverticulosis patients 85.2% were in proximal group, 5.4% in distal group and 9.4% in both group. Six (3.0%) patients were found to have diverticulitis. Multivariate logistic regression analysis showed that an old age, diabetes and the presence of polyp were significant factors associated with proximal or both diverticulosis. A significant difference was demonstrated between the patients of distal diverticular group and the controls for the symptom frequency scores within the previous 4 weeks. The items, which showed difference, were hard stool, urgency, flatus, chest discomfort and frequent urination. In conclusion, old age, diabetes and the presence of colon polyp were associated with proximal diverticulosis. The temporal symptoms were more frequent in distal diverticulosis than in proximal diverticulosis in the study subjects.
Journal of Korean medical science 09/2010; 25(9):1323-9. DOI:10.3346/jkms.2010.25.9.1323 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Diverticulitis is a well-established complication of diver-ticulosis. Data regarding the endoscopic appearance of di-verticulitis are limited, as colonoscopy is generally contrain-dicated during the acute attack, due to the increased risk of complications, especially bowel perforation. Endoscopic signs of inflammation in patients with diverticulosis are limited to the segments having the diverticulae, with rectal sparing, and appear in the literature as segmental colitis. We report a case of a middle-aged woman with diverticuli-tis who developed aphthous lesions in the rectum and sig-moid a few days after the initiation of symptoms. Other causes of aphthous lesions of the colonic mucosa (ie. Beh-cets disease, Crohn, ischemia, tuberculosis etc.) were excluded. We suggest that the presence of aphthous lesions should not be included in the setting of segmental colitis, but should be considered as endoscopic signs of diverticu-litis, possibly caused by inflammation and ischemia.
[Show abstract][Hide abstract] ABSTRACT: Approximately 15% of all patients with IBD first develop symptoms after age 65. As the number of elderly in the population continues to grow, clinicians should expect to see a greater number of elderly IBD patients. In general, the presenting features of IBD are similar to those encountered in younger patients, but the broad differential diagnosis of colitis in the elderly can make definitive diagnosis more challenging. Although most therapies for IBD have not been studied specifically in the elderly, as a general rule, medical and surgical treatment options are the same regardless of age. Osteoporosis, a condition generally associated with aging, should be managed aggressively in patients with IBD because many older persons already have a substantial baseline risk for accelerated bone loss.
Gastroenterology Clinics of North America 07/2001; 30(2):409-26. DOI:10.1016/S0889-8553(05)70188-6 · 2.82 Impact Factor
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