Long-standing colonic inflammation is associated with a low prevalence of diverticuli in inflammatory bowel disease patients.
BACKGROUND
Diverticulosis is associated with high intracolonic pressure and a weakened bowel wall. Chronic colitis is characterized by liquid stools suggestive of low intracolonic pressure and a thickened bowel wall. Therefore, the aim of this study was to assess the prevalence of diverticulosis in colitis patients.


METHODS
Colonoscopy results of patients with inflammatory bowel disease (IBD)-associated colitis older than 50 years were retrospectively evaluated and compared with those of patients who underwent screening colonoscopy. Only patients with biopsy-proven disease, disease duration of more than 5 years, and disease beyond the distal 20 cm were included.


RESULTS
In all, 1037 patients were diagnosed by colonoscopy as suffering from IBD-associated colitis between 1987-2005. After exclusion of patients who did not meet the inclusion criteria the study population consisted of 314 IBD patients and 1023 age-matched control patients. A significantly higher percent of diverticuli was detected in the control group compared with the IBD group (15% versus 3.5%, P < 0.001). No significant difference in the prevalence of diverticuli was detected between the three subtypes of IBD patients (2% in ulcerative colitis versus 4.7% in Crohn's colitis versus 7.6% in indeterminant colitis). Neither disease duration nor the specific colonic segment involved had a significant influence on the prevalence of diverticulosis.


CONCLUSIONS
Long-standing colonic inflammation in IBD patients is associated with a lower prevalence of diverticuli.
Lahat
Adi
A
Department of Gastroenterology, Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. zokadi@gmail.com
Avidan
Benjamin
B
Bar-Meir
Simon
S
Chowers
Yehuda
Y
D003092:Colitis / Q000209:etiology* / Q000473:pathology; D003113:Colonoscopy; D004241:Diverticulum, Colon / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000473:pathology; D007557:Israel / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors