Diverticula of the large bowel are out-pouchings in the wall of the colon at weak points in the circular
muscle where blood vessels penetrate to supply the mucosa. While they may occur anywhere in the colon,
they are most commonly found in the sigmoid colon where abnormalities include thickening and elastosis of
the teniae, shortening of the bowel, and thickening and folding of the circular muscle. Complications of
diverticular disease include hemorrhage, diverticulitis, peridiverticular abscess, fistula, and perforation. The
complications of diverticulosis account for the significant economic and medical costs.
The burden of diverticulosis is considerable. Using data from the National Ambulatory Medical Care
Survey and the National Hospital Ambulatory Medical Care Survey, Everhart estimated that there were 3.3
million ambulatory care visits and 815,000 hospital discharges associated with diverticular disease in 2004.
These patients received 2.4 million prescriptions written for $100 million, primarily antibiotics for complications of diverticulosis. US spending on diverticular disease has been estimated at $2.5 billion/year.3 Because diverticulosis is more common in the elderly, spending will increase as the population ages.
Despite the economic and medical burden from diverticular disease, information on the etiology is limited and asymptomatic diverticulosis has never been adequately studied. While it is generally accepted that a low fiber diet and increased luminal pressure contributes to the development of diverticulosis, there is limited information on risk factors for this disease. The goal of this study is to identify etiologic risk factors for diverticulosis.
- To describe the prevalence and demographic characteristics of asymptomatic diverticulosis among a
group of individuals undergoing first-time screening colonoscopy.
- To determine dietary and lifestyle risk factors for asymptomatic diverticulosis.
- To evaluate the association between the adherent microbial flora and diverticulosis.
- To assess local inflammation and immune activation in the colonic mucosa to support an inflammatory etiology for diverticulosis.
This study is a first step in understanding the etiology of diverticulosis with the hope of preventing the disease and its complications.
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