Diverticulosis natural history, complications and prognosis: Difference between revisions
Jump to navigation
Jump to search
YazanDaaboul (talk | contribs) |
YazanDaaboul (talk | contribs) |
||
| Line 12: | Line 12: | ||
==Complications== | ==Complications== | ||
Common complications associated with diverticulosis include:<ref name="pmid1085269">{{cite journal |vauthors=Meyers MA, Alonso DR, Gray GF, Baer JW |title=Pathogenesis of bleeding colonic diverticulosis |journal=Gastroenterology |volume=71 |issue=4 |pages=577–83 |year=1976 |pmid=1085269 |doi= |url=}}</ref><ref name="pmid4536683">{{cite journal |vauthors=Casarella WJ, Kanter IE, Seaman WB |title=Right-sided colonic diverticula as a cause of acute rectal hemorrhage |journal=N. Engl. J. Med. |volume=286 |issue=9 |pages=450–3 |year=1972 |pmid=4536683 |doi=10.1056/NEJM197203022860902 |url=}}</ref> | Common complications associated with diverticulosis include:<ref name="pmid5359917">{{cite journal |vauthors=Parks TG |title=Natural history of diverticular disease of the colon. A review of 521 cases |journal=Br Med J |volume=4 |issue=5684 |pages=639–42 |year=1969 |pmid=5359917 |pmc=1630185 |doi= |url=}}</ref> and it is the most common cause of [[lower Gastrointestinal bleeding]] in adults<ref name="pmid16303575">{{cite journal |vauthors=Strate LL |title=Lower GI bleeding: epidemiology and diagnosis |journal=Gastroenterol. Clin. North Am. |volume=34 |issue=4 |pages=643–64 |year=2005 |pmid=16303575 |doi=10.1016/j.gtc.2005.08.007 |url=}}</ref><ref name="pmid1085269">{{cite journal |vauthors=Meyers MA, Alonso DR, Gray GF, Baer JW |title=Pathogenesis of bleeding colonic diverticulosis |journal=Gastroenterology |volume=71 |issue=4 |pages=577–83 |year=1976 |pmid=1085269 |doi= |url=}}</ref><ref name="pmid4536683">{{cite journal |vauthors=Casarella WJ, Kanter IE, Seaman WB |title=Right-sided colonic diverticula as a cause of acute rectal hemorrhage |journal=N. Engl. J. Med. |volume=286 |issue=9 |pages=450–3 |year=1972 |pmid=4536683 |doi=10.1056/NEJM197203022860902 |url=}}</ref> | ||
*[[Lower gastrointestinal bleeding|Lower GI bleeding]]<ref name="pmid1085269">{{cite journal |vauthors=Meyers MA, Alonso DR, Gray GF, Baer JW |title=Pathogenesis of bleeding colonic diverticulosis |journal=Gastroenterology |volume=71 |issue=4 |pages=577–83 |year=1976 |pmid=1085269 |doi= |url=}}</ref><ref name="pmid4536683">{{cite journal |vauthors=Casarella WJ, Kanter IE, Seaman WB |title=Right-sided colonic diverticula as a cause of acute rectal hemorrhage |journal=N. Engl. J. Med. |volume=286 |issue=9 |pages=450–3 |year=1972 |pmid=4536683 |doi=10.1056/NEJM197203022860902 |url=}}</ref> | *[[Lower gastrointestinal bleeding|Lower GI bleeding]]<ref name="pmid1085269">{{cite journal |vauthors=Meyers MA, Alonso DR, Gray GF, Baer JW |title=Pathogenesis of bleeding colonic diverticulosis |journal=Gastroenterology |volume=71 |issue=4 |pages=577–83 |year=1976 |pmid=1085269 |doi= |url=}}</ref><ref name="pmid4536683">{{cite journal |vauthors=Casarella WJ, Kanter IE, Seaman WB |title=Right-sided colonic diverticula as a cause of acute rectal hemorrhage |journal=N. Engl. J. Med. |volume=286 |issue=9 |pages=450–3 |year=1972 |pmid=4536683 |doi=10.1056/NEJM197203022860902 |url=}}</ref> | ||
*[[Diverticulitis|Acute diverticulitis]]<ref name="pmid12603892">{{cite journal |vauthors=Simpson J, Spiller R |title=Colonic diverticular disease |journal=Clin Evid |volume= |issue=8 |pages=436–44 |year=2002 |pmid=12603892 |doi= |url=}}</ref><ref name="pmid1613298">{{cite journal |vauthors=Gore S, Shepherd NA, Wilkinson SP |title=Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance |journal=Int J Colorectal Dis |volume=7 |issue=2 |pages=76–81 |year=1992 |pmid=1613298 |doi= |url=}}</ref><ref name="pmid8540614">{{cite journal |vauthors=Makapugay LM, Dean PJ |title=Diverticular disease-associated chronic colitis |journal=Am. J. Surg. Pathol. |volume=20 |issue=1 |pages=94–102 |year=1996 |pmid=8540614 |doi= |url=}}</ref> | *[[Diverticulitis|Acute diverticulitis]]<ref name="pmid12603892">{{cite journal |vauthors=Simpson J, Spiller R |title=Colonic diverticular disease |journal=Clin Evid |volume= |issue=8 |pages=436–44 |year=2002 |pmid=12603892 |doi= |url=}}</ref><ref name="pmid1613298">{{cite journal |vauthors=Gore S, Shepherd NA, Wilkinson SP |title=Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance |journal=Int J Colorectal Dis |volume=7 |issue=2 |pages=76–81 |year=1992 |pmid=1613298 |doi= |url=}}</ref><ref name="pmid8540614">{{cite journal |vauthors=Makapugay LM, Dean PJ |title=Diverticular disease-associated chronic colitis |journal=Am. J. Surg. Pathol. |volume=20 |issue=1 |pages=94–102 |year=1996 |pmid=8540614 |doi= |url=}}</ref> | ||
| Line 20: | Line 20: | ||
*Abscess formation | *Abscess formation | ||
*[[Colonic stricture|Stricture]] | *[[Colonic stricture|Stricture]] | ||
==Prognosis== | ==Prognosis== | ||
*Overall, the prognosis of diverticulosis is excellent. | *Overall, the prognosis of diverticulosis is excellent. | ||
Revision as of 01:32, 3 January 2016
|
Diverticulosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Diverticulosis natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Diverticulosis natural history, complications and prognosis |
|
FDA on Diverticulosis natural history, complications and prognosis |
|
CDC on Diverticulosis natural history, complications and prognosis |
|
Diverticulosis natural history, complications and prognosis in the news |
|
Blogs on Diverticulosis natural history, complications and prognosis |
|
Risk calculators and risk factors for Diverticulosis natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D.
Overview
Diverticulosis generally develops among elderly patients (> 65 years), but it is not uncommon to be diagnosed among 40-50 years old individuals. Patients with diverticulosis are usually asymptomatic, and without development of complications, the majority of patients are not diagnosed. A minority of patients develop complications of diverticulosis. Common complications of diverticulosis include diverticular bleed, diverticulitis, abscess or fistula formation, or perforation. Overall, the prognosis of diverticulosis is excellent. The prognosis may vary based on development of complications and patient co-morbidities.
Natural History
- Diverticulosis generally develops among elderly patients (> 65 years), but it is not uncommon to be diagnosed among 40-50 years old individuals.
- Patients with diverticulosis are usually asymptomatic, and without development of complications, the majority of patients are not diagnosed.[1]
- Only 15-20% of patients with diverticulosis report symptoms that are not related to complications of the disease, such as abdominal discomfort.
- A minority (15% to 25%) of patients develop complications of diverticulosis (commonly diverticular bleed, diverticulitis, abscess or fistula formation, or perforation).[2] and it is the most common cause of lower Gastrointestinal bleeding in adults[3]
Complications
Common complications associated with diverticulosis include:[2] and it is the most common cause of lower Gastrointestinal bleeding in adults[3][4][5]
- Lower GI bleeding[4][5]
- Acute diverticulitis[1][6][7]
- Segmental colitis[8]
- Perforation
- Fistula formation
- Abscess formation
- Stricture
Prognosis
- Overall, the prognosis of diverticulosis is excellent.
- Once patients are symptomatic, mortality rates vary depending on the presence of complications and patient comorbidities.[9]. In patients with acute uncomplicated diverticulitis, conservative treatment is successful in 70 to 100 percent of patients and mortality is negligible[9].
References
- ↑ 1.0 1.1 Simpson J, Spiller R (2002). "Colonic diverticular disease". Clin Evid (8): 436–44. PMID 12603892.
- ↑ 2.0 2.1 Parks TG (1969). "Natural history of diverticular disease of the colon. A review of 521 cases". Br Med J. 4 (5684): 639–42. PMC 1630185. PMID 5359917.
- ↑ 3.0 3.1 Strate LL (2005). "Lower GI bleeding: epidemiology and diagnosis". Gastroenterol. Clin. North Am. 34 (4): 643–64. doi:10.1016/j.gtc.2005.08.007. PMID 16303575.
- ↑ 4.0 4.1 Meyers MA, Alonso DR, Gray GF, Baer JW (1976). "Pathogenesis of bleeding colonic diverticulosis". Gastroenterology. 71 (4): 577–83. PMID 1085269.
- ↑ 5.0 5.1 Casarella WJ, Kanter IE, Seaman WB (1972). "Right-sided colonic diverticula as a cause of acute rectal hemorrhage". N. Engl. J. Med. 286 (9): 450–3. doi:10.1056/NEJM197203022860902. PMID 4536683.
- ↑ Gore S, Shepherd NA, Wilkinson SP (1992). "Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance". Int J Colorectal Dis. 7 (2): 76–81. PMID 1613298.
- ↑ Makapugay LM, Dean PJ (1996). "Diverticular disease-associated chronic colitis". Am. J. Surg. Pathol. 20 (1): 94–102. PMID 8540614.
- ↑ Ludeman L, Shepherd NA (2002). "What is diverticular colitis?". Pathology. 34 (6): 568–72. PMID 12555996.
- ↑ 9.0 9.1 Rafferty J, Shellito P, Hyman NH, Buie WD (2006). "Practice parameters for sigmoid diverticulitis". Dis. Colon Rectum. 49 (7): 939–44. doi:10.1007/s10350-006-0578-2. PMID 16741596.