Summary
The association of diverticulosis with a thickened muscle wall in the pelvic colon is well known. There appeared to be a possibility that this muscular thickening might give rise to the rectosigmoidal mucosal puckering often seen through a sigmoidoscope. In 278 colonic motility studies, mucosal puckering was correlated with patient age, diverticulosis, and the symptomatology of the irritable colon syndrome. The prevalence of mucosal puckering increased with age at the same rate as that of diverticulosis, but the different percentage levels were reached some 25 years earlier in life. Mucosal puckering, which persisted in all subsequent examinations, showed no correlation with the clinical characteristics of irritable colon syndrome. Resistance of the bowel wall to distention was significantly greater in association with puckered rectosigmoidal mucosa than when the mucosa appeared smooth. It is concluded that rectosigmoidal mucosal puckering is probably caused by thickening of the underlying muscle; it is a precursor of diverticulosis, and patients who have it should be kept on a high-residue diet.
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References
Arfwidsson S, Kock NG, Lehmann L, et al: Pathogenesis of multiple diverticula of the sigmoid colon in diverticular disease. Acta Chir Scand Suppl 342: 1, 1964
Chapman M, Misiewicz JJ: Changes in the haustral pattern in diverticular disease and the irritable colon syndrome. Gut 9: 735, 1968
Hodgson J: Effect of methylcellulose on rectal and colonic pressures in treatment of diverticular disease. Br Med J 3: 729, 1972
Hughes LE: Postmortem survey of diverticular disease of the colon. Gut 10: 336, 1969
Hughes LE: A study of abnormal muscular patterns in diverticular disease of the colon using the polysiloxane foam enema. Gut 11: 111, 1970
Mayor A: Quelques mots sur une variété d’entérite iliaque. Rev Med Suisse Romande 13: 421, 1893
Morson BC: The muscle abnormality in diverticular disease of the sigmoid colon. Br J Radiol 36: 385, 1963
Ogunbiyi TA, Whitehead R: Diverticular disease of the colon (in press)
Parks TG: Natural history of diverticular disease of the colon. Br Med J 4: 639, 1969
Ritchie JA: Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut 14: 125, 1973
Ritchie JA: Mechanisms of diverticular protrusion (in press)
Slack WW: Bowel muscle in diverticular disease. Gut 7: 668, 1966
Torsoli A, Cassano CC, Aluffi A: Nota su la diverticulosi del colon. Rendic R R Gastroenterol 1: 12, 1969
Williams I: Diverticular disease of the colon: A 1968 view. Gut 9: 498, 1968
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Ritchie, J.A. Rectosigmoidal mucosal puckering and diverticulosis. Dis Colon Rectum 18, 221–227 (1975). https://doi.org/10.1007/BF02587278
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DOI: https://doi.org/10.1007/BF02587278