Diverticulosis pathophysiology


Diverticulosis is the condition of having multiple pouches (diverticula) in the colon that are not inflamed. These are outpockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall, and may be due in part to low-fiber diet prompting changes in intestinal microflora with consequent low-grade inflammation. Diverticula do not cause symptoms in most people.  Diverticular disease occurs when diverticula become clinically inflamed, a condition known as diverticulitis.

Diverticula typically occur in the sigmoid colon, which is a common place for increased pressure. The left side of the colon is more commonly affected in the United States while the right side is more commonly affected in Asia. Diagnosis is often during routine colonoscopy or as an incidental finding during CT scan.

It is common in Western countries with about half of those over the age of 60 affected in Canada and the United States. Diverticula are uncommon before the age of 40, and increase in incidence beyond that age. Rates are lower in Africa; the reasons for this remain unclear but may involve the greater prevalence of a high fiber diet in contrast with the lower-fiber diet characteristic of many Western populations.

The precise mechanisms by which diverticula are formed are unknown. Multiple theories have been proposed including genetic susceptibility, diet, intestinal motility, changes in the microbiome, and inflammation. One leading theory suggests that diverticula form in weakened areas of the colon wall that are subjected to increased pressure. The strength of the colon wall is known to decrease with age. Previous theories proposed that impacted fecal matter and certain foods would get stuck in diverticula (thereby causing trauma), which caused poor blood flow, death of the affected intestinal wall cells, and intestinal perforation. Newer theories have called this paradigm into question.

Journal of Inflammatory Bowel Diseases & Disorders brings articles in all areas related to inflammatory bowel disease, inflammatory bowel disease treatment, abdominal pain, collagenous colitis, lymphocytic colitis, diversion colitis, colon cancer, colon failure, colon disorders, intestinal endometria, bowel endometriasis, crohn's disease, celiac disease, bowel cancer, etc.

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Journal of Inflammatory Bowel Diseases and Disorders
ISSN: 2476-1958