title: Diverticular disease as a chronic gastrointestinal condition: experience from a specialist clinic.
abstract: BACKGROUND
  Although diverticular disease is a prevalent condition and a significant burden on the healthcare system, care is devolved across gastrointestinal, GP, and colorectal surgery clinics. We created a specialist Diverticular Disease Clinic to streamline care, enhance evidence-based practice and provide a base for research. The aim of this study was to assess patient referral sources, predictors of persistent disease and surgical outcomes.
  
  
  METHODS
  We retrospectively reviewed all patients attending our clinic. Patients younger than 50 years of age on initial presentation were considered 'younger' patients. Persistent symptoms lasted for at least 3 months.
  
  
  RESULTS
  Overall, 177 patients had confirmed diverticular disease. Patients were referred following hospital admission (82 patients, 46.3%) or from the community (95 patients, 53.7%). Ninety-five patients (53.7%) had persistent symptoms. Patients with more than two episodes of diverticulitis were more likely to have persistent symptoms (P<0.0001).Following hospitalization, younger patients were 3.98 times more likely to develop persistent symptoms (P=0.04). This was independent of the severity of the original infection, as a low peak C-reactive protein level of less than 50 mg/L was associated with persistent symptoms (odds ratio=3.62, P=0.03). Over the study period, 12 patients (6.9%) had elective surgery.
  
  
  CONCLUSIONS
  There is demand for dedicated care for patients with persistent symptoms from diverticular disease. Specialized clinics are a model for this care, provided by either gastroenterologists or surgeons, in centres with adequate demand. Our findings reinforce the hypotheses that chronic abdominal pain in diverticular disease may be related to sensation abnormalities similar to postinfective irritable bowel syndrome.
authors: Department of Colorectal Surgery, King's College Hospital, London.
authors: Charlotte L
authors: CL
authors: Kvasnovsky
authors: Katie
authors: K
authors: Adams
authors: Savvas
authors: S
authors: Papagrigoriadis
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors