Riccardo Nascimbeni1,2, Silvia Casiraghi3, Rosanna Cannatelli4, Francesco Lanzarotto5, Claudio Casella3, Chiara Ricci4, Vincenzo Villanacci6, Nazario Portolani7, Dario Moneghini8. 1. General Surgery, Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Brescia, Italy. riccardo.nascimbeni@unibs.it. 2. Chirurgia Generale 3, ASST Spedali Civili Brescia, Università di Brescia, Nuovo Monoblocco, Piano 6, P.le Spedali Civili 1, 25100, Brescia, Italy. riccardo.nascimbeni@unibs.it. 3. General Surgery, Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Brescia, Italy. 4. Gastroenterology, Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia, Brescia, Italy. 5. Gastroenterology, ASST Spedali Civili di Brescia, Brescia, Italy. 6. Pathology, ASST Spedali Civili di Brescia, Brescia, Italy. 7. Clinical Surgery, Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia, Brescia, Italy. 8. Endoscopy, ASST Spedali Civili di Brescia, Brescia, Italy.
Abstract
PURPOSE: Aim of this observational case-control study was to assess the prevalence, features, and risk factors of colonic diverticula in patients with ulcerative colitis (UC). METHODS: The data of 896 UC patients aged ≥ 30 years from Brescia IBD database were retrospectively analyzed. Individuals with colonic diverticula were identified and prevalence was compared with that of control patients undergoing screening colonoscopy after gender/age matching. A nested cohort study was then conducted among UC patients in order to define eventual association of diverticula with specific clinico-pathologic parameters. RESULTS: Prevalence of subjects with diverticula was 11.4% among 465 UC patients aged 49 years and older, significantly lower than 35.1% prevalence in control patients of same age and gender (p < 0.001). Advancing age was a significant risk factor for diverticula development in both groups. Among UC patients, a short duration and a late onset of UC were both significantly associated to the presence of diverticula. Moreover, UC patients with diverticula had a significantly lower frequency of flares per year, even if maximal flare severity and frequency of hospital admission were similar to those of subjects without diverticula. UC patients with diverticula had a trend toward more frequent extension of UC to the left colon, possibly because of their older age. The majority of those patients had few sigmoid diverticula without symptoms. CONCLUSIONS: Development of colonic diverticula is substantially reduced in patients with UC, markedly among those with an early onset, a long history of inflammatory disease, and a high flare frequency. This study reinforces the hypothesis sustaining a protective role of UC against colonic diverticula.
PURPOSE: Aim of this observational case-control study was to assess the prevalence, features, and risk factors of colonic diverticula in patients with ulcerative colitis (UC). METHODS: The data of 896 UC patients aged ≥ 30 years from Brescia IBD database were retrospectively analyzed. Individuals with colonic diverticula were identified and prevalence was compared with that of control patients undergoing screening colonoscopy after gender/age matching. A nested cohort study was then conducted among UC patients in order to define eventual association of diverticula with specific clinico-pathologic parameters. RESULTS: Prevalence of subjects with diverticula was 11.4% among 465 UC patients aged 49 years and older, significantly lower than 35.1% prevalence in control patients of same age and gender (p < 0.001). Advancing age was a significant risk factor for diverticula development in both groups. Among UC patients, a short duration and a late onset of UC were both significantly associated to the presence of diverticula. Moreover, UC patients with diverticula had a significantly lower frequency of flares per year, even if maximal flare severity and frequency of hospital admission were similar to those of subjects without diverticula. UC patients with diverticula had a trend toward more frequent extension of UC to the left colon, possibly because of their older age. The majority of those patients had few sigmoid diverticula without symptoms. CONCLUSIONS: Development of colonic diverticula is substantially reduced in patients with UC, markedly among those with an early onset, a long history of inflammatory disease, and a high flare frequency. This study reinforces the hypothesis sustaining a protective role of UC against colonic diverticula.
Entities:
Keywords:
Colonic diverticula; Diverticular disease; Natural history of ulcerative colitis; Ulcerative colitis
Authors: Claudio Cassieri; Roberta Pica; Eleonora V Avallone; Maddalena Zippi; Pietro Crispino; Daniela De Nitto; Paolo Paoluzi; Giovanni Brandimarte; Piera Giuseppina Lecca; Walter Elisei; Marcello Picchio; Antonio Tursi Journal: J Clin Gastroenterol Date: 2016-10 Impact factor: 3.062
Authors: S N Reddy; G Bazzocchi; S Chan; K Akashi; J Villanueva-Meyer; G Yanni; I Mena; W J Snape Journal: Gastroenterology Date: 1991-11 Impact factor: 22.682
Authors: I O Gordon; N Agrawal; E Willis; J R Goldblum; R Lopez; D Allende; X Liu; D Y Patil; L Yerian; F El-Khider; C Fiocchi; F Rieder Journal: Aliment Pharmacol Ther Date: 2018-02-06 Impact factor: 8.171