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Colon diverticulosis

Lukasz Krokowicz, Adam Bobkiewicz, Maciej Borejsza-Wysocki, Barbara Kuczynska, Aleksandra Lisowska, Urszula Skowronska-Piekarska, Jacek Paszkowski, Jaroslaw Walkowiak, Michal Drews, Tomasz Banasiewicz
The term constipation with regard to patients with a stoma is defined as impaired bowel movements associated with increased stool consistency or long periods without bowel movements that lead to discomfort, flatulence, and abdominal pain. Information about constipation in patients with a stoma is limited. A prospective, descriptive study was conducted among patients attending ostomy and proctology outpatient clinics in Poznan, Poland between January 2011 and December 2014 to assess the role of dietary and pharmacological strategies in the management of constipation in patients with a stoma...
December 2015: Ostomy/wound Management
D S Ahmad, E E Quist, G F Hutchins, I Bhat
The development of colonic diverticula is common in developed countries and complications of colonic diverticulosis are responsible for a remarkable burden of the disease. The natural history and management of complicated and recurrent diverticulitis in young patients are still a matter of debate. Coloenteric fistula is a rare complication of diverticulitis in young adults. In this report, and utilising a case study, we will review the natural history, outcome and management of acute diverticulitis in the young...
October 2016: Netherlands Journal of Medicine
Edith Lahner, Bruno Annibale
Diverticular disease (DD) is a common gastrointestinal condition. Clinical spectrum ranges from asymptomatic diverticulosis to symptomatic uncomplicated or complicated DD. Symptoms related to uncomplicated DD are not specific and may be indistinguishable from those of irritable bowel syndrome. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors potentially contributing to symptoms. Probiotics may modify the gut microbial balance leading to health benefits...
November 2016: Journal of Clinical Gastroenterology
Hugh J Freeman
Segmental colitis associated diverticulosis (SCAD) has become increasingly appreciated as a form of inflammatory disease of the colon. Several features suggest that SCAD is a distinct disorder. SCAD tends to develop almost exclusively in older adults, predominately, but not exclusively, males. The inflammatory process occurs mainly in the sigmoid colon, and usually remains localized to this region of the colon alone. SCAD most often presents with rectal bleeding and subsequent endoscopic visualization reveals a well localized process with non-specific histopathologic inflammatory changes...
September 28, 2016: World Journal of Gastroenterology: WJG
Antonio Tursi, Marcello Picchio, Walter Elisei, Francesco Di Mario, Carmelo Scarpignato, Giovanni Brandimarte
BACKGROUND: Management of diverticular disease (DD) remains a point of debate. GOALS: To investigate the current opinion of participants of the 2nd International Symposium on Diverticular Disease, on real-life management of patients with DD of the colon. STUDY: Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. RESULTS: In total, 115 surveys from 8 European Countries were filled out...
October 2016: Journal of Clinical Gastroenterology
Antonio Tursi, Paola Mastromarino, Daniela Capobianco, Walter Elisei, Alfredo Miccheli, Giorgio Capuani, Alberta Tomassini, Giuseppe Campagna, Marcello Picchio, GianMarco Giorgetti, Federica Fabiocchi, Giovanni Brandimarte
GOAL: The aim of this study was to assess fecal microbiota and metabolome in a population with symptomatic uncomplicated diverticular disease (SUDD). BACKGROUND: Whether intestinal microbiota and metabolic profiling may be altered in patients with SUDD is unknown. PATIENTS AND METHODS: Stool samples from 44 consecutive women [15 patients with SUDD, 13 with asymptomatic diverticulosis (AD), and 16 healthy controls (HCs)] were analyzed. Real-time polymerase chain reaction was used to quantify targeted microorganisms...
October 2016: Journal of Clinical Gastroenterology
Rudi De Bastiani, Guido Sanna, Pierluigi Fracasso, Maurizio D'Urso, Edoardo Benedetto, Antonio Tursi
GOALS: To investigate the current opinion of Italian general practitioners (GPs) on the management of patients with diverticular disease (DD) of the colon. BACKGROUND: The management of DD remains a point of debate, and guidelines are not uniform in their advice. STUDY: A web-based survey was conducted among Italian GPs. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. RESULTS: In total, 245 surveys were filled out...
October 2016: Journal of Clinical Gastroenterology
Carmelo Scarpignato, Anna Bertelé, Antonio Tursi
Changes in the colonic microbiota are critical to the pathogenesis of diverticular complications such as diverticulitis and peridiverticular abscesses. However, more subtle changes in microbiota composition may well be important to the more chronic manifestations of diverticulosis. Some studies have shown the presence of bacterial overgrowth in subgroups of patients with diverticular disease and recent studies, using molecular biology techniques, found an increase of proteobacteria and actinobacteria in patients with symptomatic uncomplicated diverticular disease (SUDD), compared with healthy controls...
October 2016: Journal of Clinical Gastroenterology
Giovanni Barbara, Cesare Cremon, Maria R Barbaro, Lara Bellacosa, Vincenzo Stanghellini
Colonic diverticulosis is an increasingly common condition in Western industrialized countries. About 20% of patients develop symptoms, including abdominal pain, bloating, changes in bowel habits, and, eventually, diverticulitis or other complications. The management of symptomatic uncomplicated diverticular disease (SUDD) and the prevention of acute diverticulitis remains a challenge for the clinician. The rationale for the use of aminosalicylates, such as mesalazine, is based on the assumption of low-grade inflammation in SUDD and symptoms generation, whereas an overt inflammation may induce diverticulitis in patients with diverticular disease...
October 2016: Journal of Clinical Gastroenterology
Claudio Cassieri, Giovanni Brandimarte, Walter Elisei, Giuseppina P Lecca, Elisabetta Goni, Antonio Penna, Marcello Picchio, Antonio Tursi
The segmental colitis associated with diverticulosis," better known by its acronym "SCAD," is a chronic inflammatory process localized in the colonic area presenting diverticulosis, and therefore mainly in the sigmoid colon. By definition, both the rectum and the right colon are spared from any inflammation both endoscopically and from a histologic point of view. Recent data have hypothesized that SCAD may be an independent clinical entity within the inflammatory bowel disease set of diseases. Compared with inflammatory bowel disease, SCAD seems to have a more benign outcome, with low rate of complications...
October 2016: Journal of Clinical Gastroenterology
Claudio Cassieri, Roberta Pica, Eleonora V Avallone, Maddalena Zippi, Pietro Crispino, Daniela De Nitto, Paolo Paoluzi, Giovanni Brandimarte, Piera Giuseppina Lecca, Walter Elisei, Marcello Picchio, Antonio Tursi
BACKGROUND: Diverticulosis of the colon is an acquired condition that results from herniation of the mucosa and submucosa through defects in the muscular layer. The true prevalence of colonic diverticulosis is difficult to measure because most individuals are asymptomatic. In particularly, in literature, there are few studies about the prevalence of colonic diverticulosis in patients affected by ulcerative colitis (UC). GOALS: To investigate the prevalence of colonic diverticulosis in UC and in adult patients referred in a single center...
October 2016: Journal of Clinical Gastroenterology
Antonella Gallo, Gianluca Ianiro, Massimo Montalto, Giovanni Cammarota
Diverticulosis of the colon is a common condition in western countries. Acute diverticulitis may occur in 10% to 25% of the patients, sometimes associated with the presence of complications such as abscess, fistula, and perforation. Early diagnosis and accurate assessment of acute diverticulitis are necessary to start an efficacious treatment promptly, either conservatively or by surgery. The clinical picture may mimic other abdominal conditions; therefore, imaging techniques such as ultrasound or computed tomography are usually recommended, although they are expensive, examiner dependent, and potentially harmful...
October 2016: Journal of Clinical Gastroenterology
Nicola Flor, Simone Soldi, Edoardo Zanchetta, Sara Sbaraini, Filippo Pesapane
Different scenarios embrace computed tomography imaging and diverticula, including asymptomatic (diverticulosis) and symptomatic patients (acute diverticulitis, follow-up of acute diverticulitis, chronic diverticulitis). If the role of computed tomography is validated and widely supported by evidence in case of acute diverticulitis, this is not the case of patients in their follow-up for acute diverticulitis or with symptoms related to diverticula, but without acute inflammation. In these settings, computed tomography colonography is gaining consensus as the preferred radiologic test...
October 2016: Journal of Clinical Gastroenterology
Antonio Tursi, Giovanni Brandimarte, Francesco Di Mario, Walter Elisei, Carmelo Scarpignato, Marcello Picchio
Diverticular inflammation and complication assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease. Its predictive value in those patients was recently retrospectively assessed. For each patient, the following parameters were recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein, fecal calprotectin test (if available) at the time of diagnosis, months of follow-up, therapy taken during the follow-up to maintain remission (if any), occurrence/recurrence of diverticulitis, and need of surgery...
October 2016: Journal of Clinical Gastroenterology
Giovanni Barbara, Eleonora Scaioli, Maria Raffaella Barbaro, Elena Biagi, Luca Laghi, Cesare Cremon, Giovanni Marasco, Antonio Colecchia, Gianfranco Picone, Nunzio Salfi, Francesco Capozzi, Patrizia Brigidi, Davide Festi
OBJECTIVE: The engagement of the gut microbiota in the development of symptoms and complications of diverticular disease has been frequently hypothesised. Our aim was to explore colonic immunocytes, gut microbiota and the metabolome in patients with diverticular disease in a descriptive, cross-sectional, pilot study. DESIGN: Following colonoscopy with biopsy and questionnaire phenotyping, patients were classified into diverticulosis or symptomatic uncomplicated diverticular disease; asymptomatic subjects served as controls...
September 12, 2016: Gut
Adegboyega Akere, Temitope Olufemi Oke, Jesse Abiodun Otegbayo
BACKGROUND AND AIM: Colonoscopy is considered the gold standard for diagnosing structural colonic diseases. It is safe and effective both for diagnosis and therapeutic interventions. This study was carried out to evaluate the pattern of indications and spectrum of colonic disease at a tertiary healthcare facility in Southwest Nigeria. PATIENTS AND METHODS: All consenting patients who were referred for colonoscopy were recruited into the study. A proforma was used to record information such as biodata of the patients, indications for the procedure, and the findings at colonoscopy...
July 2016: Annals of African Medicine
Antonio Tursi, Giovanni Brandimarte, Francesco Di Mario, Maria L Annunziata, Mauro Bafutto, Maria A Bianco, Raffaele Colucci, Rita Conigliaro, Silvio Danese, Rudi De Bastiani, Walter Elisei, Ricardo Escalante, Roberto Faggiani, Luciano Ferrini, Giacomo Forti, Giovanni Latella, Maria G Graziani, Enio C Oliveira, Alfredo Papa, Antonio Penna, Piero Portincasa, Kjetil Søreide, Antonio Spadaccini, Paolo Usai, Stefanos Bonovas, Carmelo Scarpignato, Marcello Picchio, Piera G Lecca, Costantino Zampaletta, Claudio Cassieri, Alberto Damiani, Kari F Desserud, Serafina Fiorella, Rosario Landi, Elisabetta Goni, Maria A Lai, Flavia Pigò, Gianluca Rotondano, Giuseppe Schiaccianoce
BACKGROUND: Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease. AIMS: We assessed retrospectively the predictive value of DICA in patients for whom endoscopic data and clinical follow-up were available. METHODS: For each patient, we recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein and faecal calprotectin test (if available) at the time of diagnosis; months of follow-up; therapy taken during the follow-up to maintain remission (if any); occurrence/recurrence of diverticulitis; need of surgery...
August 2016: United European Gastroenterology Journal
Hayim Gilshtein, Yoram Kluger, Areen Khoury, Nidal Issa, Wisam Khoury
AIM: Diverticular hemorrhage may be massive or recurrent, requiring surgical management. The aim of our study is to define risk factors that predict rebleeding or need for urgent operation in patients with diverticular hemorrhage. METHODS: Retrospective study was conducted on patients who were admitted for diverticular hemorrhage. Data pertaining to patient and bleeding characteristics, method of diagnosis, blood transfusion and type of operation were collected...
September 2016: International Journal of Surgery
Veeravich Jaruvongvanich, Anawin Sanguankeo, Karn Wijarnpreecha, Sikarin Upala
BACKGROUND: Diverticular disease and colorectal neoplasia are common digestive disorders worldwide. Both diseases share epidemiologic trends and certain risk factors including advancing age, physical activity, and western diet and lifestyle. Studies assessing the association between those diseases reported inconsistent results. Thus, we conducted a systematic review and meta-analysis to determine the association between diverticular disease and colorectal adenomas, advanced adenomas and cancer...
July 25, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Maurizio Koch, Virginia Festa, Francesca Chiesara, Alessandra Moretti, Marco Bianchi, Angelo Dezi
Diverticular disease (DD) of the colon has an increasing burden on health service resources, in terms of hospital admissions, mortality and surgery rate. We present an overview of the clinical history of DD, and of the ways that gastroenterologists have to modify it. Prevalence of the disease increases with aging. Most of diverticulosis are occasionally identified on colonscopy, and most of them remain asymptomatic for all life. Only 4% of these subjects develop diverticulitis. However, 4-25% of these patients are expected to present a second episode of diverticulitis, and 15% of them develop complications...
June 2016: Recenti Progressi in Medicina
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