title: Symptomatic Diverticulosis Is Characterized By Loose Stools.
abstract: Symptomatic uncomplicated diverticular disease is considered to be a discreet clinical entity distinct from irritable bowel syndrome (IBS), but population-based data are unavailable. We aimed to investigate the prevalence and location of diverticulosis in the general population, and its association with colonic symptoms and mental health. We propose that individuals with diverticulosis would report more constipation and IBS.
  
  
  
  We performed a population-based study of randomly selected adults born in Sweden (age, 18-70 y; 57.2% women); 745 received a gastroenterology consultation, completed validated abdominal symptom and mental health questionnaires, and were examined by colonoscopy. Logistic regression was used to calculate the associations between diverticulosis and age, sex, gastrointestinal symptoms, anxiety, depression, and self-rated health.
  
  
  
  Among the 742 participants (54.6% women), 130 (17.5%) had diverticulosis. Age was the strongest predictor of diverticulosis (P < .001), and diverticulosis was rare in participants younger than 40 years (0.7%). All participants with diverticulosis had sigmoid involvement. Participants with diverticulosis were more likely to report loose stools (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.20-2.96), urgency (OR, 1.64; 95% CI, 1.02-2.63), passing mucus (OR, 2.26; 95% CI, 1.08-4.72), and a high stool frequency (OR, 2.02; 95% CI, 1.11-3.65). Diverticulosis was associated with abdominal pain (OR, 2.10; 95% CI, 1.01-4.36; P = .047) and diarrhea-predominant IBS (OR, 9.55; 95% CI, 1.08-84.08; P = .04) in participants older than 60 years. The presence of anxiety and depression and self-rated health were similar in participants with and without diverticulosis.
  
  
  
  The prevalence of diverticulosis is age-dependent. Diverticulosis is associated with diarrhea in subjects across all age ranges. In subjects older than age 60, diverticulosis is associated with abdominal pain and diarrhea-predominant IBS.
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Gastroenterology, Baylor College of Medicine, Houston, Texas. Electronic address: ellionore.jarbrink@ki.se.
authors.forename: M Ellionore
authors.initials: ME
authors.lastname: Järbrink-Sehgal
authors.affiliation: Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Andreasson
authors.affiliation: Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.affiliation: Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Agréus
authors.affiliation: Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Division of Gastroenterology, Department of Internal Medicine, Leechuntek Hospital, Suwon, Korea.
authors.forename: Jeong-Yeop
authors.initials: JY
authors.lastname: Song
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Schmidt
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology*; D004240:Diverticulum / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Colonoscopy; Diverticulosis; Irritable Bowel Syndrome (IBS); Population-Based; Symptomatic Uncomplicated Diverticular Disease (SUDD)