Prevalence and Distribution of Colonic Diverticular Disease from Ordu in Turkey

Year 2019, , 206 - 211, 31.12.2019

Nergiz Ekmen Çağrı Akalın

https://doi.org/10.19127/mbsjohs.622380

Abstract

Objective: Diverticulosis of the colon is the
most frequent anatomical alteration diagnosed at colonoscopy. Most cases of
diverticulosis in Western countries involve left side of the colon, while
diverticulosis is predominantly present on the right side of the colon in Asian
countries. With the aim of this study is to contribute to epidemiologic studies
on colonic diverticula in Turkey located in Europe and Asian continent. We
analyzed the data of patients undergoing colonoscopy with regard to age,
gender, anatomic localization of diverticula retrospectively in the Ordu State
Hospital in the Black Sea region.

Methods: We retrospectively reviewed a
consecutive series of patients with regard to age, gender, location of
diverticula and other colonoscopic lesions from an electronic endoscopic
database who had undergone colonoscopy at the endoscopy unit of the Ordu State
Hospital between 2016 and 2018. If diverticula were observed that distribution
type was defined as cecum, ascending colon, transverse colon, descending colon,
entire colon and sigmoid colon. In addition, we recorded that the additional
diagnoses established in colonoscopic evaluations.

Results: We screened 2626 female (51.1%) and
2511 male (48.9%); totally 5137 patients from an electronic endoscopic database
who had undergone colonoscopy. 227 (47.4%) female, 252 (52.6%) male, a total of
479 patients who had diverticulosis were included in this study. The mean age
was determined female and male 65.44±12.01 (min 31-max 91), 64.91±10.97 (min
27-max 89) respectively and no statistically significant difference between two
groups (p>0.05). A total of 479 patients who had diverticulosis were divided
into two groups:  age ≤ 50 (10.4%) and 50> 429 (89.6%). No significant
difference was found with regard to diverticulosis localization between two
groups (p>0.05). The other colonoscopic diagnoses are as follows; hemorrhoid
(40.7%), polyp (40.2%), inflammatory bowel disease (4.7%) colorectal cancer
(0.9%), angiodysplasia (2.3%), ulcer (0.9%), anal fissure (1.9%), parasitosis
(1.9%), terminal ileitis (0.5%), nonspecific colitis (3.7%), bowel surgery
(1.9%) and submucosal lesion (0.5%).

Conclusion: Diverticular
disease is a worldwide condition that affect elderly people with an increasing
incidence in younger patients as well as in developing countries that have
started adopting Western diets. So that in the future diverticular disease will
induce a significant economic burden in terms of healthcare cost in Turkey. Despite
its prevalence, its pathophysiology still remains poorly understood. There is a
significant need for more studies to improve our understanding about
diverticular disease.

Keywords

Colonoscopy, colonic diverticular disease, diverticulosis localization

References

• Alatise OI, Arigbabu AO, Agbakwuru EA, Lawal OO, Ndububa DA, Ojo OS. Spectrum of colonoscopy findings in Ile‐Ife Nigeria. Niger Postgrad Med J 2012;19:219-24.
• Alessandra V, Ginevra C, Chiara M, Alberto B, Antonio N, Mario C, et al. Epidemiology and risk factors for diverticular disease. Acta Biomed 2018;89:107-112.
• Baako BN. Diverticular disease of the colon in Accra, Ghana. Brit J Surg 2001;88:1595.
• Blachut K, Paradowski L, Garcarek J. Prevalence and distribution of the colonic diverticulosis. Review of 417 cases from Lower Silesia in Poland. Rom J Gastroenterol 2004;13:281-285.
• Celebi A, Teker F, Gurler M, Koc DO, Ozdemir AA. Characteristics of the Patients Undergoing Colonoscopy in a Single Center within an 8-year Period. J Gastrointest Dig Syst 2017;7:3.
• Delvaux M. Diverticular disease of the colon in Europe: epidemiology, impact on citizen health and prevention. Aliment Pharmacol Ther 2003;18:71-4.
• Floch MH, Bina I. The natural history of diverticulitis: fact and theory. J Clin Gastroenterol 2004;38:2-7.
• Imaeda H, Hibi T. The burden of diverticular disease and its complications: west versus east. Inflamm Intest Dis 2018;3:61-68.
• Imbembo AL, Bailey RW. Diverticular disease of the colon. In: Textbook of Surgery, 14th ed, Sabiston DC Jr (Ed), Churchill Livingstone, 1992. p.910.
• Nagata N, Niikura R, Aoki T, Shimbo T, Itoh T, Goda Y, et al. Increase in colonic diverticulosis and diverticular hemorrhage in an aging society: lessons from a 9-year colonoscopic study of 28,192 patients in Japan. Int J Colorectal Dis 2014;29:379-385.
• Ngoi SS, Chia J, Goh MY, Sim E, Rauff A. Surgical management of right colon diverticulitis. Dis Colon Rectum. 1992;35:799–802.
• Painter NS, Burkitt DP. Diverticular disease of the colon: a deficiency disease of Western civilization. Br Med J 1971;2:450-454.
• Parks TG. Natural history of diverticular disease of the colon: a review of 521 cases. Br Med J. 1969;4:639-42.
• Peery AF, Crockett SD, Barritt AS, Dellon ES, Eluri S, Gangarosa LM, et al. Burden of gastrointestinal, liver, and pancreatic diseases in the United States. Gastroenterology 2015;149:1731-1741.
• Tamer A, Korkut E, Korkmaz U, Akcan Y. Low gastrointestinal endoscopy, an instutional results: Region of Duzce. The Medical Journal of Kocatepe 2005;6:29-31.
• Sharara AI, El-Halabi MM, Mansour NM, Malli A, Ghaith OA, Hashash JG, et al. Alcohol consumption is a risk factor for colonic diverticulosis. J Clin Gastroenterol. 2013;47:420-5.
• Song JH, Kim YS, Lee JH, Ok KS, Ryu SH, Lee JH, et al. Clinical characteristics of colonic diverticulosis in Korea: a prospective study. Korean J Intern Med 2010;25:140-6.
• Tursi A, Inchingolo CD, Picchio M, Elisei W, Mangiola F, Gasbarrini G. Histopathology of segmental colitis associated with diverticulosis resembles inflammatory bowel diseases. J Clin Gastroenterol 2015;49:350-1.
• Yilmaz S, Bayan K, Tuzun Y, Canoruc F. Colonoscopic lesions and histopathological results: evalutation of 322 patients. The Turkish Journal of Academic Gastroenterology 2006;5:184-187.
• Wang FW, Chuang HY, Tu MS, King TM, Wang JH, Hsu CW, et al. Prevalence and risk factors of asymptomatic colorectal diverticulosis in Taiwan. BMC Gastroenterol 2015;15:40.
• Warner E, Crighton EJ, Moineddin R, Mamdani M, Upshur R. Fourteen-year study of hospital admissions for diverticular disease in Ontario. Can J Gastroenterol 2007;21:97-9