Disorders of the Colon

Diverticulosis

Definition & pathophysiology (Aliment Pharm Ther 2015;42:664)

  • Acquired herniations of colonic mucosa & submucosa in areas where vasa recta penetrate
  • Thought to occur in setting of abnormal motility and ↑ intraluminal pressure

Epidemiology

  • Risk factors: ↓ fiber, ↑ red meat, obesity, smoking, physical inactivity, EtOH, NSAIDs
  • Prevalence higher w/ ↑ age (10% if <40 y; 50–66% if >80 y); “Westernized” societies
  • Left side (90%, mostly sigmoid) > R side of colon (except in Asia where 75–85% R-sided)

Clinical manifestations

  • Usually asx, but 5–15% develop diverticular hemorrhage (see “GIB”) and 5% diverticulitis