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Ulcerative colitis and the aging-related development of colonic diverticula

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Aim of this observational case-control study was to assess the prevalence, features, and risk factors of colonic diverticula in patients with ulcerative colitis (UC).

Methods

The data of 896 UC patients aged ≥ 30 years from Brescia IBD database were retrospectively analyzed. Individuals with colonic diverticula were identified and prevalence was compared with that of control patients undergoing screening colonoscopy after gender/age matching. A nested cohort study was then conducted among UC patients in order to define eventual association of diverticula with specific clinico-pathologic parameters.

Results

Prevalence of subjects with diverticula was 11.4% among 465 UC patients aged 49 years and older, significantly lower than 35.1% prevalence in control patients of same age and gender (p < 0.001). Advancing age was a significant risk factor for diverticula development in both groups. Among UC patients, a short duration and a late onset of UC were both significantly associated to the presence of diverticula. Moreover, UC patients with diverticula had a significantly lower frequency of flares per year, even if maximal flare severity and frequency of hospital admission were similar to those of subjects without diverticula. UC patients with diverticula had a trend toward more frequent extension of UC to the left colon, possibly because of their older age. The majority of those patients had few sigmoid diverticula without symptoms.

Conclusions

Development of colonic diverticula is substantially reduced in patients with UC, markedly among those with an early onset, a long history of inflammatory disease, and a high flare frequency. This study reinforces the hypothesis sustaining a protective role of UC against colonic diverticula.

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Authors and Affiliations

  1. General Surgery, Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Brescia, Italy

    Riccardo Nascimbeni, Silvia Casiraghi & Claudio Casella

  2. Chirurgia Generale 3, ASST Spedali Civili Brescia, Università di Brescia, Nuovo Monoblocco, Piano 6, P.le Spedali Civili 1, 25100, Brescia, Italy

    Riccardo Nascimbeni

  3. Gastroenterology, Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia, Brescia, Italy

    Rosanna Cannatelli & Chiara Ricci

  4. Gastroenterology, ASST Spedali Civili di Brescia, Brescia, Italy

    Francesco Lanzarotto

  5. Pathology, ASST Spedali Civili di Brescia, Brescia, Italy

    Vincenzo Villanacci

  6. Clinical Surgery, Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia, Brescia, Italy

    Nazario Portolani

  7. Endoscopy, ASST Spedali Civili di Brescia, Brescia, Italy

    Dario Moneghini

Authors
  1. Riccardo Nascimbeni
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  2. Silvia Casiraghi
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  3. Rosanna Cannatelli
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  4. Francesco Lanzarotto
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  5. Claudio Casella
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  6. Chiara Ricci
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  7. Vincenzo Villanacci
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  8. Nazario Portolani
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  9. Dario Moneghini
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Corresponding author

Correspondence to Riccardo Nascimbeni.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Cite this article

Nascimbeni, R., Casiraghi, S., Cannatelli, R. et al. Ulcerative colitis and the aging-related development of colonic diverticula. Int J Colorectal Dis 33, 1277–1283 (2018). https://doi.org/10.1007/s00384-018-3040-8

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  • DOI: https://doi.org/10.1007/s00384-018-3040-8

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