Diverticular disease associated with inflammatory bowel disease-like colitis: a systematic review.
OBJECTIVE
Diverticular-associated colitis significantly overlaps clinically with primary inflammatory bowel disease. However, the clinical and the pathologic features of diverticular-associated colitis suggest that it is a distinct clinical entity.


METHODS
We performed a systematic review by use of multiple health care databases and gray literature, following predefined inclusion and exclusion criteria to determine the clinical, endoscopic, and pathologic features of diverticular-associated colitis, and recurrence rates following medical and surgical treatment.


RESULTS
Two hundred twenty-seven participants were selected from 18 eligible studies, including our own patients (n = 13). The average age of disease onset was 64 years. The typical symptoms included tenesmus, hematochezia, and diarrhea. One hundred sixty-three of the 227 patients in these studies were classified as having diverticular-associated colitis, of which 142 were managed medically. Twenty-eight patients eventually required an operation. One-quarter (37 of 163) of the patients had recurrence of symptoms with an average follow-up time of three years.


CONCLUSIONS
Diverticular-associated colitis is a distinct entity that presents with segmental colitis and a variety of clinical, endoscopic, and pathologic features. Diverticular-associated colitis should be considered in the presence of recurrent symptoms after resection for diverticulitis.
Mulhall
Aaron M
AM
Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA.
Mahid
Suhal S
SS
Petras
Robert E
RE
Galandiuk
Susan
S
D017668:Age of Onset; D003092:Colitis / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D004239:Diverticulitis, Colonic / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D012008:Recurrence