diverticulosis

Definition & pathophysiology (Aliment Pharm Ther 2015;42:664)

• Acquired herniations of colonic mucosa & submucosa in areas where vasa recta penetrate
• Abnormal motility and ↑ intraluminal pressure cause protrusion of colonic wall Epidemiology
• Risk factors: ↓ fiber, chronic constipation, obesity, smoking, physical inactivity, EtOH, NSAIDs, ↑ age (10% if <40 y; 50–66% if >80 y); ↑ red meat consumption
• Left side (90%, mostly sigmoid) >R side of colon (except in Asia where 75–85% R-sided) Clinical manifestations
• Usually asx; 5–15% develop diverticular hemorrhage (see “GIB”) and 10–25% diverticulitis
• Limited data for ↑ fiber diet or avoiding nuts/seeds (Thera Adv Gastro 2016;9:213)