title: A hypothesis: is diverticulitis a type of inflammatory bowel disease?
abstract: It is accepted by epidemiologists that diverticula formation in the colon is related to a deficiency in dietary fiber intake, but the cause of acute diverticulitis remains unknown. A hypothesis is presented that acknowledges from the literature that fiber deficiency is also related to an altered intestinal microecology with a change in the bacterial flora. It is hypothesized that the change in the flora with a decrease in their influence on the immune process permits a low-grade chronic inflammation in the mucosa, which is the first step in developing an acute infection of diverticula or diverticulitis. There is some evidence that the low-grade chronic inflammation is present in subjects with diverticula, which is the forerunner of acute diverticulitis. This hypothesis is strengthened by early reports that anti-inflammatory mucosal agents such as mesalamine and immune process regulators such as probiotics may improve diverticulitis.
authors.affiliation: Section of Digestive Disease, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Floch
mesh_terms: D001419:Bacteria / Q000254:growth & development; D004043:Dietary Fiber / Q000172:deficiency; D004239:Diverticulitis, Colonic / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D007249:Inflammation; D015212:Inflammatory Bowel Diseases / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology; D007413:Intestinal Mucosa / Q000276:immunology / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology