Diagnosis of Diverticulosis Might Not Mean Bigger Problems

Diverticulosis patients had lower risk of diverticulitis than previously thought says new study

(RxWiki News) After colonoscopy, some patients are told they have diverticulosis — a diagnosis that might lead to worry. But a new study says the risk of this condition turning into the more serious diverticulitis may be lower than previously thought.

This new study looked at patients from the Veterans Affairs Healthcare System in Los Angeles who were diagnosed with these sacs on the colon — a condition known as diverticulosis.

Though previous estimates had shown that these patients have a 10 to 25 percent risk of developing more serious issues, this new study found the risk for complications to be much lower.

"Talk to your doctor about colonoscopy."

According to the authors of this study, led by Brennan Spiegel, MD, MSHS, of the David Geffen School of Medicine at the University of California, Los Angeles, diverticulosis is a common finding during colonoscopy and often causes concern.

Diverticulosis is a condition in which pouches or sacs develop in the lining of the colon. For many, the pouches of diverticulosis are symptomless, according to the National Digestive Diseases Information Clearinghouse (NDDIC). Sometimes, however, a condition called diverticulitis can develop if the pouches become inflamed or irritated. Diverticulitis can involve symptoms like abdominal pain, fever, nausea, constipation, diarrhea and vomiting, reported NDDIC.

"Colonic diverticulosis is the most common finding during routine colonoscopy, and patients often question the significance of these lesions," explained Dr. Spiegel and colleagues. "Guidelines state that these patients have a 10 percent to 25 percent lifetime risk of developing acute diverticulitis."

However, these researchers also explained that these estimates were based on limited data and further research was needed to determine more accurate rates of diverticulitis among people who were diagnosed with diverticulosis during a routine colonoscopy.

To do this, Dr. Spiegel and team utilized data from the Veterans Affairs Greater Los Angeles Healthcare System to identify people who underwent a colonoscopy from January 1996 to January 2011.

These researchers identified 2,222 patients who had diverticulosis during the study period. These patients were followed for an average of 6.75 years.

Dr. Spiegel and team identified 95 of these patients (4.3 percent) who developed diverticulitis based on a loose definition that did not require confirmation through a computed tomography (CT) scan. This loose definition accounted for a rate of six diverticulitis cases per 1,000 patient-years.

The researchers identified 23 patients (1 percent) who developed diverticulitis based on a more rigorous definition that did involve confirming the condition with a CT scan or with surgery. This definition accounted for a rate of of 1.5 diverticulitis cases per 1,000 patient-years.

Patients who did develop diverticulitis were younger (with an average age of 63.8 years) than those who did not develop the condition (with an average age of 67 years old). The authors of this study reported that for each additional year of age at the time of diverticulosis diagnosis, the patient had a 2.4 percent lower risk of developing diverticulitis during the study.

Further research is needed to understand the risk of diverticulitis and to explore the differences seen among different age groups.

"Despite these limitations, these results question the traditional teaching about the rate of progression from incidental diverticulosis to acute diverticulitis," Dr. Spiegel and colleagues wrote. "Moreover, they also suggest that patients who are diagnosed with diverticulosis at a younger age may incur more risk of developing diverticulitis."

They concluded, "These data may help to reframe discussions with patients regarding their probability of developing clinically significant diverticulitis."

This study was published in the December issue of Clinical Gastroenterology and Hepatology. Dr. Spiegel has received research support from several pharmaceutical companies and several other study authors are employees of Shire Pharmaceuticals.

Review Date: 
December 3, 2013