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Diverticular associated colitis

Marjorie M Walker, Angela K Harris
Diverticulosis is defined by the presence of diverticula due to herniation of mucosa and muscularis mucosa through the muscularis propria at sites of vascular penetration in the colon and is asymptomatic in the vast majority affected. There are global differences of distribution, in Western industrialised societies, the most common site is in the right colon, but in Asia left sided diverticulosis predominates. Whilst present in 17.5% of a general population and 42% of all comers at endoscopy it is seen in 71% of those aged ≥80 years...
December 14, 2016: Minerva Gastroenterologica e Dietologica
Sreedhar Subramanian, Anders Ekbom, Jonathan M Rhodes
The genetics of isolated colonic Crohn's disease place it approximately midway between Crohn's disease with small intestinal involvement and UC, making a case for considering it as a separate condition. We have therefore systematically reviewed its epidemiology, pathophysiology and treatment. Key findings include a higher incidence in females (65%) and older average age at presentation than Crohn's disease at other sites, a mucosa-associated microbiota between that found in ileal Crohn's disease and UC, no response to mesalazine, but possibly better response to antitumour necrosis factor than Crohn's disease at other sites...
February 2017: Gut
Joseph D Feuerstein, Kenneth R Falchuk
Diverticular disease is a common condition that is associated with variable presentations. For this review article, we performed a review of articles in PubMed through February 1, 2016, by using the following MeSH terms: colon diverticula, colonic diverticulitis, colonic diverticulosis, colonic diverticulum, colonic diverticula, and diverticula. Diverticula are structural alterations within the colonic wall that classically form "pockets" referred to as diverticula. Diverticula form from herniation of the colonic mucosa and submucosa through defects in the circular muscle layers within the colonic wall...
August 2016: Mayo Clinic Proceedings
Roisin Bevan, Wee Sing Ngu, Brian P Saunders, Zacharias Tsiamoulos, Paul Bassett, Zoe Hoare, Colin J Rees
BACKGROUND: Colonoscopy is the gold standard investigation for the diagnosis of bowel pathology and colorectal cancer screening. Adenoma detection rate is a marker of high quality colonoscopy and a high adenoma detection rate is associated with a lower incidence of interval cancers. Several technological advancements have been explored to improve adenoma detection rate. A new device called Endocuff Vision™ has been shown to improve adenoma detection rate in pilot studies. METHODS/DESIGN: This is a prospective, multicenter, randomized controlled trial comparing the adenoma detection rate in patients undergoing Endocuff Vision™-assisted colonoscopy with standard colonoscopy...
February 2016: Endoscopy International Open
Polychronis Pavlidis, Ingvar Bjarnason
Aspirin is in many ways a non- steroidal anti-inflammatory drug (NSAID) prototype. Similar to conventional NSAIDs the gastric side effects of aspirin are well studied. However its potential adverse effects on the small and large intestine are less well known and under- researched. Experimental studies support a pathogenic pathway leading to NSAID enteropathy involving the topical effects on the intestinal barrier (mucous layer, enterocytes) that lead to dysfunction and increased intestinal permeability followed by increased exposure to luminal triggers and acute inflammation...
2015: Current Pharmaceutical Design
Johann P Hreinsson, Solrun Palsdóttir, Einar S Bjornsson
OBJECTIVES: Studies on the association of acute lower gastrointestinal bleeding (ALGIB) and drugs are scarce. We aimed to investigate the association of drugs and ALGIB, especially regarding specific causes of ALGIB, and their role in the severity of ALGIB. MATERIALS AND METHODS: The study was prospective and included all patients undergoing colonoscopy in 2010 and 2013 at the National University Hospital of Iceland. Use of nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin (LDA), and warfarin before ALGIB was registered...
May 2016: Journal of Clinical Gastroenterology
Jami Kinnucan, Justin Tomal, David T Rubin
BACKGROUND: Studies outside the United States have described a lower prevalence of diverticulosis in patients with inflammatory bowel disease (IBD) than in patients without IBD. The aim of this study was to assess the prevalence of diverticulosis and associated risk factors in patients with ulcerative colitis (UC) at a U.S. tertiary care center. METHODS: We performed a retrospective review of patients over 50 years of age who underwent screening or surveillance colonoscopy from January 2006 to December 2013...
September 2015: Inflammatory Bowel Diseases
Edouard Louis
PURPOSE OF REVIEW: Inflammatory bowel diseases (IBDs) represent a heterogeneous entity whose diagnosis is sometimes difficult to ascertain. Many pathological processes may mimic IBD phenotypes. Among the classical differential diagnoses are enteric infections and infestations as well as drug toxicity. However, recently, more specific differential diagnoses have been included, including monogenic causes of gastrointestinal tract inflammation, particularly in young children. The purpose of the present review is to describe the differential diagnosis of IBD, putting it in a specific clinical and demographic context...
July 2015: Current Opinion in Gastroenterology
Antonio Tursi
Diverticulosis of the colon is frequently found on routine colonoscopy, and the incidence of diverticular disease and its complications appears to be increasing. The role of colonoscopy in managing this disease is still controversial. Colonoscopy plays a key role in managing diverticular bleeding. Several techniques have been effectively used in this field, but band ligation seems to be the best in preventing rebleeding. Colonoscopy is also effective in posing a correct differential diagnosis with other forms of chronic colitis involving colon harbouring diverticula (in particular with Crohn's disease or Segmental Colitis Associated with Diverticulosis)...
March 2015: Journal of Gastrointestinal and Liver Diseases: JGLD
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No abstract text is available yet for this article.
February 2015: Journal of Crohn's & Colitis
Liying Dai, Denis W King, D Shevy Perera, David Z Lubowski, Elizabeth Burcher, Lu Liu
BACKGROUND: Prostaglandin E2 (PGE2) is the dominant prostaglandin in the colon and is associated with colonic inflammation. PGE2 levels are regulated not only by cyclooxygenases (COX-1 and COX-2) but also by 15-hydroxyprostaglandin dehydrogenase (15-PGDH), the major PGE2-degrading enzyme. Information about the involvement of 15-PGDH in colonic inflammation is sparse. AIM: We thus aimed to determine the gene expression and immunoreactivity (IR) of COX-1, COX-2, and 15-PGDH in colonic mucosa from patients with diverse inflammatory disorders: ulcerative colitis (UC), Crohn's disease (CD), and acute diverticular disease (DD)...
May 2015: Digestive Diseases and Sciences
Neil A Shepherd
Chronic inflammatory bowel disease (CIBD) infers ulcerative colitis, Crohns disease and the pathological spectrum between, encompassing indeterminate colitis in resections and IBDU on biopsy. Histological assessment remains the gold standard for CIBD diagnosis and yet there are many conditions that show pathological mimicry of CIBD. It cannot be overemphasised that context is a critical determinant of the pathological diagnosis in inflamed colorectal biopsies.The lecture will focus on drug-induced colitis, diverticular colitis, focal active colitis, microscopic colitis and secondary colitis...
October 2014: Pathology
Gianluca Costa, Marco La Torre, Brabara Frezza, Pietro Fransvea, Federico Tomassini, Vincenzo Ziparo, Genoveffa Balducci
PURPOSE: The present study aims to determine the morbidity and mortality of emergency colonic surgery and the factors associated with adverse outcome, and to evaluate any change in incidence of the different types of pathological conditions and in the surgical approach over the last 15 years. MATERIALS AND METHODS: A total of 319 patients who underwent emergency colonic surgery between January 1997 and December 2011 were retrospectively analyzed. Patients were divided into two groups according to the date of surgery, namely group 1, between 1997 and 2006, and group 2, between 2006 and 2011...
2014: Digestive Surgery
Tara M Connelly, Arthur S Berg, John P Hegarty, Sue Deiling, David Brinton, Lisa S Poritz, Walter A Koltun
OBJECTIVE: To determine if single nuclear polymorphisms (SNPs) in the TFNSF15 gene play a role in patients requiring surgery for diverticulitis. BACKGROUND: A role for a genetic predisposition in diverticulitis is suggested by its association with hereditary connective tissue disorders, youthful onset in some patients, and the observation of families with multiple affected individuals. The TNFSF15 gene has been associated with other inflammatory diseases affecting the colon such as medically refractory ulcerative colitis (UC), aggressive Crohn's disease (CD), and pouchitis after restorative proctocolectomy...
June 2014: Annals of Surgery
J P Gisbert, M Chaparro
BACKGROUND: Elderly patients represent an increasing proportion of the inflammatory bowel disease (IBD) population. AIM: To critically review available data regarding the care of elderly IBD patients. METHODS: Bibliographic searches (MEDLINE) up to June 2013. RESULTS: Approximately 10-15% of cases of IBD are diagnosed in patients aged >60 years, and 10-30% of the IBD population are aged >60 years. In the elderly, IBD is easily confused with other more common diseases, mainly diverticular disease and ischaemic colitis...
March 2014: Alimentary Pharmacology & Therapeutics
Kiyonori Kobayashi, Miyuki Mukae, Taishi Ogawa, Kaoru Yokoyama, Miwa Sada, Wasaburo Koizumi
AIM: To evaluate the clinical usefulness of single-balloon endoscopy (SBE) in patients in whom a colonoscope was technically difficult to insert previously. METHODS: The study group comprised 15 patients (8 men and 7 women) who underwent SBE for colonoscopy (30 sessions). The number of SBE sessions was 1 in 7 patients, 2 in 5 patients, 3 in 1 patient, 4 in 1 patient, and 6 in 1 patient. In all patients, total colonoscopy was previously unsuccessful. The reasons for difficulty in scope passage were an elongated colon in 6 patients, severe intestinal adhesions after open surgery in 4, an elongated colon and severe intestinal adhesions in 2, a left inguinal hernia in 2, and multiple diverticulosis of the sigmoid colon in 1...
March 16, 2013: World Journal of Gastrointestinal Endoscopy
Alba H Norsa, Massimo Tonolini, Sonia Ippolito, Roberto Bianco
BACKGROUND: Water enema multidetector computed tomography (WE-MDCT) is currently considered the most accurate imaging modality to provide high-resolution multiplanar visualisation of the colonic wall and surrounding structures. METHODS: This pictorial review presents our experience with WE-MDCT applications outside colorectal tumour staging, particularly for investigating diverticular disease and chronic inflammatory bowel diseases. A detailed explanation of the technique is provided, including patient preparation, the acquisition protocol, and study interpretation...
June 2013: Insights Into Imaging
Cord Langner
Collagenous and lymphocytic colitis are common causes of chronic watery diarrhea that are characterized by distinct histopathologic abnormalities without endoscopically visible lesions and are summarized as microscopic colitis. Several variants of microscopic colitis have been described, although their clinical significance still has to be defined. Preserved mucosal architecture is a histologic hallmark of microscopic colitis and distinguishes the disease from inflammatory bowel disease (IBD). In addition to architectural abnormalities, the diagnosis of IBD rests on characteristic inflammatory changes...
September 2012: Gastroenterology Clinics of North America
Boris Vestweber, Thomas Galetin, Kathrin Lammerting, Claudia Paul, Jeanette Giehl, Eberhard Straub, Bodo Kaldowski, Angelika Alfes, Karl-Heinz Vestweber
BACKGROUND: Compared with single-incision laparoscopy, multiport laparoscopy is associated with greater risk of postoperative wound pain, infection, incisional hernias, and suboptimal cosmetic outcomes. The feasibility of minimally invasive single-incision laparoscopic surgery (SILS) for colorectal procedures is well-established, but outcome data remain limited. METHODS: Patients with benign diverticular disease, Crohn's disease, or ulcerative colitis admitted to Klinikum Leverkusen, Germany, for colonic resection between July 2009 and March 2011 (n = 224) underwent single-incision laparoscopic surgery using the SILS port system...
February 2013: Surgical Endoscopy
A Tursi, W Elisei, G Brandimarte, G M Giorgetti, C D Inchingolo, R Nenna, M Picchio, F Giorgio, E Ierardi
BACKGROUND: Inflammation may be detected in diverticular disease (DD), and fibrosis may also develop. We assessed the mucosal expression of bFGF, SD1, and TNF-α in DD according to the severity of the disease. Moreover, we assessed the response to therapy of these cytokines in acute uncomplicated diverticulitis (AUD). METHODS: Fifteen patients affected by AUD and seven patients affected by symptomatic uncomplicated diverticular disease (SUDD) were enrolled. Patients with asymptomatic diverticulosis (AD), segmental colitis associated with diverticulosis (SCAD), ulcerative colitis (UC), and healthy subjects (HC) served as control groups...
September 2012: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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