title: Association between the location of diverticular disease and the irritable bowel syndrome: a multicenter study in Japan.
abstract: OBJECTIVE
  No previous reports have shown an association between location of diverticular disease (DD) and the irritable bowel syndrome (IBS).
  
  
  METHODS
  We included 1,009 consecutive patients undergoing total colonoscopy in seven centers in Japan from June 2013 to September 2013. IBS was diagnosed using Rome III criteria, and diverticulosis was diagnosed by colonoscopy with transparent soft-short-hood. Left-sided colon was defined as sigmoid colon, descending colon, and rectum. Right-sided colon was defined as cecum, ascending colon, and transverse colon. We divided the patients into IBS and non-IBS groups and compared characteristics.
  
  
  RESULTS
  Patient characteristics included mean age, 64.2±12.9 years and male:female ratio, 1.62:1. Right-sided DD was identified in 21.6% of subjects. Left-sided and bilateral DD was identified in 6.6 and 12.0% of subjects, respectively. IBS was observed in 7.5% of subjects. Multiple logistic regression analysis showed left-sided DD (odds ratio, 3.1; 95% confidence interval (CI): 1.4-7.1; P=0.0060) and bilateral DD (odds ratio, 2.6; 95% CI, 1.3-5.2; P=0.0070) were independent risk factors for IBS. Right-sided DD was not a risk factor for IBS.
  
  
  CONCLUSIONS
  Our data showed that the presence of left-sided and bilateral DD, but not right-sided disease, was associated with a higher risk of IBS, indicating that differences in pathological factors caused by the location of the DD are important in the development of IBS. Clarifying the specific changes associated with left-sided DD could provide a better understanding of the pathogenic mechanisms of IBS (Trial registration # R000012739).
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Yamada
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.affiliation: Department of Gastroenterology, Machida Municipal Hospital, Machida, Tokyo, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Uchida
authors.affiliation: Department of Gastroenterology, Machida Municipal Hospital, Machida, Tokyo, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Tanida
authors.affiliation: Department of Gastroenterology, Machida Municipal Hospital, Machida, Tokyo, Japan.
authors.forename: Motoyoshi
authors.initials: M
authors.lastname: Izumi
authors.affiliation: Department of Gastroenterology, International University of Health and Welfare Atami Hospital, Atami, Shizuoka, Japan.
authors.forename: Kimiya
authors.initials: K
authors.lastname: Takeshita
authors.affiliation: Department of Gastroenterology, Tokyo Metropolitan, Hiroo General Hospital, Shibuya-ku, Tokyo, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Department of Gastroenterology, Yokosuka City Hospital, Yokosuka, Kanagawa, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Komatsu
authors.affiliation: Department of Gastroenterology, Yokohama Minami Kyosai Hospital, Yokosuka, Kanagawa, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hamanaka
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Department of Gastroenterology, Machida Municipal Hospital, Machida, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kanesaki
authors.affiliation: Department of Gastroenterology, NTT Medical Center Tokyo, Gotanda, Tokyo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D004241:Diverticulum, Colon / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000473:pathology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000473:pathology*; D013223:Statistics as Topic; D055815:Young Adult