New knowledge on the diverticular disease of colon
Authors:
Mojmír Dolejší
Authors‘ workplace:
Univerzita Karlova v Praze, 1. lékařská fakulta, IV. interní klinika VFN
Published in:
Čas. Lék. čes. 2011; 150: 651-655
Category:
Review Article
Overview
The article is a summary paper aimed at new knowledge, concerning the classification, diagnostics, medication and endoscopic treatment of diverticular disease of colon. Briefly mentioned are the issues of functional disorder in the field of diverticulosis - symptomatic uncomplicated diverticular disease of colon. Diverticular bleeding is explained in terms of its pathogenesis and diagnostics. The problem with estimation the ration of diverticular bleedings in the total number of bleedings into the lower digestive tract is caused by diverse criteria for selecting patients and two levels of diagnostic of diverticular bleeding (definite and presumptive). Attention is paid also to diverticular colitis. Synonyms, endoscopic and histological classification are listed. The main endoscopic findings represent areas of erythema, which are visible on the mucosa between diverticula. Diverticulitis is seen as the most significant complication and the diagnostics of diverticulitis is discussed in detail. The first recommended step in the diagnosis is an urgent abdominal ultrasound; the gold standard is a CT examination of the abdomen, in special situations, some other imaging methods should be used: MRI, colonoscopy. The article ends with an overview of modern therapeutic options in the treatment of diverticular colitis and diverticulitis, particularly the use of antibiotics, probiotics, mesalasine and antispasmodics. Negative effect of NSAIDs on the course of diverticulitis and induction diverticular bleeding is listed.
Key words:
diverticular bleeding, diverticular colitis, diverticulitis.
Sources
1. Antoš F. Divertikulární choroba tlustého střeva. In: Gastroenterologie. Mařatka Z. Praha: Karolinum 1999; 305–309.
2. Colecchia A., Sandri L., Capodicasa S, et al. Diverticular disease of the colon: New perspectives in symptom development and treatment. World J Gastroenterol 2003: 9(7): 1385–1389.
3. Hollerbach S. Diverticular disease – differential diagnosis and prognosis. In: Diverticular Disease: Emerging Evidence in a Common Condition. Berlin: Springer-Verlag 2006; s. 37–43.
4. Fearnhead NS, Mortensen NJ. Clinical features and diferencial diagnosis of diverticular disease. Best Practice Research Clinical Gastroenterology 2002; 16: 577–593.
5. Halligan S, Saunders B. Imaging diverticular disease. Best Practice Research Clinical Gastroenterology 2002; 16: 595–610.
6. Pilichos P, Bobotis E. Role of endoscopy in the managemnet af acute diverticular bleeding. World J. Gastroenterol 2008, 14: 1981–1983.
7. Schölmerich J. Lower gastrointestinal bleeding – search for sources. In: Diverticular Disease: Emerging Evidence in a Common Condition. Berlin: Springer-Verlag 2006; s. 61–66.
8. Jensen DM, Machicado GA, et al. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage. N England J Med 2000; 342: 78–82.
9. Tursi A. Segmental Colitis Associated with Diverticulosis: Complication of Diverticular Disease or Autonomous Entity? Dig Dis Sci 2011; 56: 27–34.
10. Sakurai Y. Clinical problem of diverticular disease of colon. Gastroenterological Endoscopy 2005; 47: 1205–1210.
11. Haboubi NY, Khattab A, Edilbe MW. Patterns of mucosal inflammation in diverticular disease. In: Diverticular Disease: Emerging Evidence in a Common Condition. Berlin: Springer-Verlag 2006; 3–16.
12. Hadithi M, Cazemier M, et al. Retrospective analysis of old-age colitis in th Dutch inflammatory bowel disease population. World J Gastroenterol 2008; 14: 3183-3187
13. Freeman JH. Segmental colitis associated with diverticulosis syndrome. World J Gastroenterol 2008; 14: 6442–6443.
14. Delvaux M. Diverticular disease of the colon in Europe: epidemiology, impakt on citizen health and prevention. Aliment Pharmacol Ther 2003; 18: 71–74.
15. Parra-Blanco A. Colonic Diverticular Disease: Pathophysiology and Clinical Picture. Digestion 2006; 73: 47–57.
16. Hollerweger A, Macheiner P, et al. Colonic diverticulitis: diagnostic value and apperance of inflamed diverticula-sonographic evaluation. Eur Radiol 2001; 11: 1956–1963.
17. Oudenhoven L, Koumans R, Puylaert J. Right Colonic Diverticulitis: US and CT Findings-New Insights about Frequency and Natural History. Radilogy 1998; 208: 611–618.
18. Hollerweger A, Rettenbacher T, et al. Sigmoid diverticulitis: Value of Transrectal Sonography in Addition to Transabdominal Sonography. Amer J Radiol 2000; 175: 1155–1160.
19. Hollerweger A. Colonic diseases: The value of US examination. Eur J Radiol 2007; 64: 239–249.
20. Rao PM, Rhea JT. Colonic Diverticulitis: Evaluation of the Arrowhead Sign and the Inflamed Diverticulum for CT Diagnosis. Radiology 1998; 209: 775–779.
21. Lohrmann Ch, Ghanem N, et al. CT in acute perforated sigmoid diverticulitis. Eur J Radiol 2005; 56: 78–83.
22. Ferda J, Mírka H, Ferdová E, Kreuzberg B. Divertikulární nemoc. In: CT trávicí trubice. Praha: Galén 2006; s. 182–187.
23. Latella G, Pimpo MT, Sotilli S, et al. Rifaximin improves symptomps of acquired uncomplicated diverticular disease od the colon. Int J Colorectal Dis 2003; 18: 55–62.
24. Frič P, Zavoral M. Escherichia coli Nissle 1917 prolongs remission in symptomatic uncomplicated diverticular disease of the colon. In: Falk Symposium 2005; 148.
25. Tursi A. Diverticular disease: A therapeutic overview. World J Gastrointest Pharmacol Ther 2010; 6: 27–35.
26. Gross V. Aminosalicylates. In: Diverticular Disease: Emerging Evidence in a Common Condition. Berlin: Springer-Verlag 2006; s. 175–182.
27. Piekarek K, Isrealsson LA. Perforated colonic diverticular disease: the importance of NSAIDs, opioids, corticosteroids, and calcium channel blockers. Int J Colorectal Dis 2008; 23(12): 1193–1197.
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
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