0

0044 (0)2089016477

Early Surgery Common for Uncomplicated Diverticulitis

Elective colon resection is often performed after fewer than three previous episodes of uncomplicated diverticulitis, according to research published online Feb. 10 in JAMA Surgery.

Elective colon resection is often performed after fewer than three previous episodes of uncomplicated diverticulitis, according to research published online Feb. 10 in JAMA Surgery.

Vlad V. Simianu, M.D., M.P.H., of the University of Washington in Seattle, and colleagues conducted a nationwide, retrospective cohort study from 2009 to 2012 to assess patterns of episodes of diverticulitis before surgery and factors associated with early surgery. Data were analyzed from inpatient, outpatient, and antibiotic prescription claims for diverticulitis in MarketScan (Truven Health Analytics) databases.

The researchers found that 5,604 (6.4 percent) of 87,461 immunocompetent patients with at least one claim for diverticulitis underwent a resection. In the final study cohort of 3,054 nonimmunocompromised patients who underwent elective surgery for uncomplicated diverticulitis, more than half (55.6 percent) were male.

“The concerned, informed, and ethical surgeon will adhere to the recommendations proposed by almost all of the national surgical societies to improve the care for patients with diverticulitis and avoid operation on early uncomplicated diverticulitis,” writes the author of an accompanying editorial.

New irritable bowel syndrome (IBS) symptoms can emerge after acute bout of diverticulitis. The findings uncovered by the UCLA researchers may help provide better pain relief for patients suffering from this new form of IBS.

Post-diverticulitis irritable bowel syndrome (PDV-IBS) reveals that symptoms related to IBS can still be experienced after bouts of diverticulitis, but many practitioners believed these symptoms to be part of the original condition.

Senior author Dr. Brennan Spiegel said, “We’ve known for a long time that after some people develop diverticulitis, they’re a different person. They experience recurrent abdominal pains, cramping and diarrhea that they didn’t have before. The prevailing wisdom has been that once diverticulitis is treated, it’s gone. But we’ve shown that IBS symptoms occur after the diverticulitis, and it may result from an inflammatory process like a bomb going off in the body and leaving residual damage.”
Diverticulosis is a condition where pouches develop along the intestines, colon, and even stomach. The risk of diverticulitis increases with age, with over 50 percent of patients being over 60. Generally, the pouches do not cause any issues. The inflammation of the pouches is what is known as   diverticulitis. The condition is accompanied by the abdominal pain and infection.

Spiegel added, “A major surprise in our study was that diverticulitis patients not only developed IBS at a higher rate than the controls, but they also developed mood disorders like depression and anxiety at a higher rate. Because IBS and mood disorders often go hand in hand, this suggests that acute diverticulitis might even set off a process leading to long-standing changes in the brain-gut axis.”

Discovering PDV-IBS could mean better treatment for patients when they experience symptoms after a bout of diverticulitis.

“Patients often report ongoing IBS symptoms after the diverticulitis has long passed, and this study supports their beliefs and introduces a new diagnosis. If doctors recognize this, they may take the symptoms more seriously and manage them actively, just as they can manage IBS actively with various new drugs on the market and currently in development,” said Spiegel.

The study looked at over 1,000 patient records of patients who experienced diverticulitis and those who had not. Patients were paired with same-age, sex and comorbidities controls.

Spiegel explained, “This study expands our understanding a little bit about what might cause IBS. It’s such a common condition and there may be different flavors. We’ve now added a new flavor to the menu, a new risk factor for developing IBS. By learning more, we might be able to expand the therapies we can use on these patients.”