title: Increased risk for irritable bowel syndrome after acute diverticulitis.
abstract: OBJECTIVE
  Individuals with diverticulosis frequently also have irritable bowel syndrome (IBS), but there are no longitudinal data to associate acute diverticulitis with subsequent IBS, functional bowel disorders, or related emotional distress. In patients with postinfectious IBS, gastrointestinal disorders cause long-term symptoms, so we investigated whether diverticulitis might lead to IBS. We compared the incidence of IBS and functional bowel and related affective disorders among patients with diverticulitis.
  
  
  METHODS
  We performed a retrospective study of patients followed up for an average of 6.3 years at a Veteran's Administration medical center. Patients with diverticulitis were identified based on International Classification of Diseases, 9th revision codes, selected for the analysis based on chart review (cases, n = 1102), and matched with patients without diverticulosis (controls, n = 1102). We excluded patients with prior IBS, functional bowel, or mood disorders. We then identified patients who were diagnosed with IBS or functional bowel disorders after the diverticulitis attack, and controls who developed these disorders during the study period. We also collected information on mood disorders, analyzed survival times, and calculated adjusted hazard ratios.
  
  
  RESULTS
  Cases were 4.7-fold more likely to be diagnosed later with IBS (95% confidence interval [CI], 1.6-14.0; P = .006), 2.4-fold more likely to be diagnosed later with a functional bowel disorder (95% CI, 1.6-3.6; P < .001), and 2.2-fold more likely to develop a mood disorder (CI, 1.4-3.5; P < .001) than controls.
  
  
  CONCLUSIONS
  Patients with diverticulitis could be at risk for later development of IBS and functional bowel disorders. We propose calling this disorder postdiverticulitis IBS. Diverticulitis appears to predispose patients to long-term gastrointestinal and emotional symptoms after resolution of inflammation; in this way, postdiverticulitis IBS is similar to postinfectious IBS.
authors.affiliation: Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Erica
authors.initials: E
authors.lastname: Cohen
authors.forename: Garth
authors.initials: G
authors.lastname: Fuller
authors.forename: Roger
authors.initials: R
authors.lastname: Bolus
authors.forename: Rusha
authors.initials: R
authors.lastname: Modi
authors.forename: Michelle
authors.initials: M
authors.lastname: Vu
authors.forename: Kamyar
authors.initials: K
authors.lastname: Shahedi
authors.forename: Rena
authors.initials: R
authors.lastname: Shah
authors.forename: Mary
authors.initials: M
authors.lastname: Atia
authors.forename: Nicole
authors.initials: N
authors.lastname: Kurzbard
authors.forename: Victoria
authors.initials: V
authors.lastname: Sheen
authors.forename: Nikhil
authors.initials: N
authors.lastname: Agarwal
authors.forename: Marc
authors.initials: M
authors.lastname: Kaneshiro
authors.forename: Linnette
authors.initials: L
authors.lastname: Yen
authors.forename: Paul
authors.initials: P
authors.lastname: Hodgkins
authors.forename: M Haim
authors.initials: MH
authors.lastname: Erder
authors.forename: Brennan
authors.initials: B
authors.lastname: Spiegel
mesh_terms: D000328:Adult; D000368:Aged; D004238:Diverticulitis / Q000150:complications*; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment
keywords: CI; CT; Colon; Functional Gastrointestinal Disease; HR; IBS; ICD-9; Inflammatory Disorder; International Classification of Diseases, 9th revision; Outcome; PDV-IBS; PI-IBS; VAGLAHS; Veterans Affairs Greater Los Angeles Healthcare System.; computed tomography; confidence interval; hazard ratio; irritable bowel syndrome; postdiverticulitis irritable bowel syndrome; postinfectious irritable bowel syndrome