Colonic Diverticulosis Is Not Associated With Painful Abdominal Symptoms in a US Population.
Irritable Bowel Syndrome
Painful Diverticular Disease
Symptomatic Diverticulosis
Symptomatic Uncomplicated Diverticular Disease
Journal
Gastro hep advances
ISSN: 2772-5723
Titre abrégé: Gastro Hep Adv
Pays: Netherlands
ID NLM: 9918350485906676
Informations de publication
Date de publication:
2022
2022
Historique:
entrez:
13
7
2022
pubmed:
14
7
2022
medline:
14
7
2022
Statut:
ppublish
Résumé
Symptomatic uncomplicated diverticular disease is a controversial diagnosis defined as chronic gastrointestinal symptoms in patients with diverticulosis. We assessed whether individuals with diverticulosis had an increased risk of abdominal pain, irritable bowel syndrome, or altered bowel habits. We performed a prospective cohort study of participants who had a first-time screening colonoscopy at the University of North Carolina between 2013 and 2015. The colonoscopy included a detailed assessment for diverticulosis. Participants completed a follow-up interview between 2019 and 2020 to measure bowel habits and gastrointestinal symptoms. Poisson regression was used to estimate relative risk and 95% confidence intervals (CIs). Among the 310 participants, 128 (41%) had diverticulosis at baseline. Follow-up interviews were performed a mean of 6.8 years after the baseline colonoscopy. After adjustment for confounders, there was no association between diverticulosis and abdominal pain lasting >24 hours (relative risk [RR], 0.40; 95% CI, 0.05-3.45) or symptoms of irritable bowel syndrome (RR, 1.30; 95% CI, 0.69-2.42) at the time of follow-up. Compared to those with no diverticulosis, participants with diverticulosis were more likely to have more frequent bowel movements per day (RR, 1.60; 95% CI, 1.05-2.44). The association was stronger in participants with >10 diverticula (RR, 2.03; 95% CI, 1.19-3.48). Diverticulosis was not associated with altered stool consistency. These findings suggest that diverticulosis is associated with more frequent bowel movements contrary to the widespread belief that patients with diverticulosis are constipated. Diverticulosis was not associated with abdominal pain or symptoms of irritable bowel syndrome. The diagnosis of symptomatic uncomplicated diverticular disease must be reconsidered.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Symptomatic uncomplicated diverticular disease is a controversial diagnosis defined as chronic gastrointestinal symptoms in patients with diverticulosis. We assessed whether individuals with diverticulosis had an increased risk of abdominal pain, irritable bowel syndrome, or altered bowel habits.
METHODS
METHODS
We performed a prospective cohort study of participants who had a first-time screening colonoscopy at the University of North Carolina between 2013 and 2015. The colonoscopy included a detailed assessment for diverticulosis. Participants completed a follow-up interview between 2019 and 2020 to measure bowel habits and gastrointestinal symptoms. Poisson regression was used to estimate relative risk and 95% confidence intervals (CIs).
RESULTS
RESULTS
Among the 310 participants, 128 (41%) had diverticulosis at baseline. Follow-up interviews were performed a mean of 6.8 years after the baseline colonoscopy. After adjustment for confounders, there was no association between diverticulosis and abdominal pain lasting >24 hours (relative risk [RR], 0.40; 95% CI, 0.05-3.45) or symptoms of irritable bowel syndrome (RR, 1.30; 95% CI, 0.69-2.42) at the time of follow-up. Compared to those with no diverticulosis, participants with diverticulosis were more likely to have more frequent bowel movements per day (RR, 1.60; 95% CI, 1.05-2.44). The association was stronger in participants with >10 diverticula (RR, 2.03; 95% CI, 1.19-3.48). Diverticulosis was not associated with altered stool consistency.
CONCLUSION
CONCLUSIONS
These findings suggest that diverticulosis is associated with more frequent bowel movements contrary to the widespread belief that patients with diverticulosis are constipated. Diverticulosis was not associated with abdominal pain or symptoms of irritable bowel syndrome. The diagnosis of symptomatic uncomplicated diverticular disease must be reconsidered.
Identifiants
pubmed: 35821706
doi: 10.1016/j.gastha.2022.04.001
pmc: PMC9273073
mid: NIHMS1820943
doi:
Types de publication
Journal Article
Langues
eng
Pagination
659-665Subventions
Organisme : NIDDK NIH HHS
ID : P30 DK034987
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK094738
Pays : United States
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors disclose no conflicts.
Références
Colorectal Dis. 2017 Jun;19(6):O168-O176
pubmed: 28436177
Cell Mol Gastroenterol Hepatol. 2020;9(1):15-32
pubmed: 31351939
Clin Gastroenterol Hepatol. 2005 Mar;3(3):248-53
pubmed: 15765444
Clin Gastroenterol Hepatol. 2016 Dec;14(12):1763-1770.e1
pubmed: 27353142
Int J Colorectal Dis. 2012 Sep;27(9):1151-9
pubmed: 22573184
Viszeralmedizin. 2015 Apr;31(2):76-82
pubmed: 26989376
Am J Gastroenterol. 2015 Nov;110(11):1589-96
pubmed: 26416187
Gastroenterology. 2012 Feb;142(2):266-72.e1
pubmed: 22062360
Dis Mon. 1970 Jun;:3-57
pubmed: 4913873
Scand J Gastroenterol. 2021 Nov;56(11):1264-1270
pubmed: 34411502
Nat Rev Dis Primers. 2020 Mar 26;6(1):20
pubmed: 32218442
Am J Epidemiol. 1989 Jan;129(1):125-37
pubmed: 2910056
Clin Gastroenterol Hepatol. 2018 Jun;16(6):884-891.e1
pubmed: 28603053
Clin Gastroenterol Hepatol. 2013 Dec;11(12):1614-9
pubmed: 23524129
Am J Gastroenterol. 2019 Mar;114(3):500-510
pubmed: 30839393
Dig Dis. 2012;30(1):64-9
pubmed: 22572688
Clin Gastroenterol Hepatol. 2013 Dec;11(12):1622-7
pubmed: 23891924
Am J Epidemiol. 2004 Apr 1;159(7):702-6
pubmed: 15033648
Int J Colorectal Dis. 2014 May;29(5):571-7
pubmed: 24562545
Scand J Gastroenterol. 1997 Sep;32(9):920-4
pubmed: 9299672
JAMA. 2008 Aug 27;300(8):907-14
pubmed: 18728264
Clin Gastroenterol Hepatol. 2016 Jul;14(7):980-985.e1
pubmed: 26872402
J Clin Gastroenterol. 2015 Mar;49(3):218-21
pubmed: 24583746
Clin Gastroenterol Hepatol. 2020 Aug;18(9):1980-1986
pubmed: 31634580
Neurogastroenterol Motil. 2014 Oct;26(10):1458-68
pubmed: 25109425
Clin Gastroenterol Hepatol. 2018 Jun;16(6):817-818
pubmed: 29155169
Gastroenterology. 2021 Feb;160(3):906-911.e1
pubmed: 33279517
Br Med J. 1971 May 22;2(5759):450-4
pubmed: 4930390
Surg Endosc. 1999 Apr;13(4):430-6
pubmed: 10094765
Eur J Clin Invest. 2013 Nov;43(11):1147-55
pubmed: 23992370