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Increase in colonic diverticulosis and diverticular hemorrhage in an aging society: lessons from a 9-year colonoscopic study of 28,192 patients in Japan

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Abstract

Purposes

Colonoscopic evidence of epidemiological trends in diverticulosis and diverticular bleeding is scarce. We evaluated trends in diverticular disease and associated factors over 9 years.

Methods

Twenty-eight thousand one hundred ninety-two patients who underwent colonoscopy at an emergency hospital were reviewed from an electronic endoscopy database. Diverticula were classified as right-sided, left-sided, and bilateral types, and time trends in the proportion in diverticulosis, type, and diverticular bleeding were determined. Associations of age (≤39, 40–59, and ≥60 years), sex, and year increase with disease and odds ratios were estimated using logistic regression.

Results

Diverticulosis was identified in 6,150 patients (20.3 %; mean age, 67.6 years) and was predominantly right-sided (48.0 %). Diverticular bleeding was found in 427 (1.5 %; mean age, 69.7 years) and was predominantly bilateral (47.0 %). Proportion of colonic diverticulosis increased significantly (P < 0.01 for trend) from 66.0 % (1,424/2,157) in 2003 to 70.1 % (2,914/4,159) in 2011 and was associated (P < 0.01) with an increased number of patients aged ≥60 years. Proportion of diverticular bleeding increased significantly (P < 0.01 for trend) from 1.02 % (22/2,157) in 2003 to 1.67 % (69/4,159) in 2011 and was associated (P = 0.04) with an increased number of patients aged 40–59 years. Diverticulosis, right and bilateral type, and diverticular bleeding were independently associated with the 9-year trend after adjustment by age and sex.

Conclusions

Colonic diverticulosis and diverticular bleeding are prevalent and increasing in Japan. Given the significant association of age with this trend, both diseases can be expected to increase for decades to come.

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Acknowledgments

We wish to express our gratitude to Clinical Research Coordinators Hisae Kawashiro, Sawako Iijima, Yoko Tanigawa, Aiko Gotanda, and Yaeko Sawada for their help with data collection. This study was supported in part by a Grant-in-Aid from the Ministry of Health Labor and Welfare of Japan and a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (271000) and The Grant of National Center for Global Health and Medicine (22–302). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Naoyoshi Nagata, Ryota Niikura, Tomonori Aoki, Junichi Akiyama & Mikio Yanase

  2. Clinical Research and Informatics, International Clinical Research Center Research Institute, National Center for Global Health and Medicine, Tokyo, Japan

    Takuro Shimbo

  3. Clinical Research Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan

    Toshiyuki Itoh

  4. Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan

    Yoshimasa Goda, Ryuichiro Suda & Hideaki Yano

  5. The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan

    Masashi Mizokami

  6. Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan

    Naomi Uemura

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  1. Naoyoshi Nagata
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Correspondence to Naoyoshi Nagata.

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Nagata, N., Niikura, R., Aoki, T. 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 29, 379–385 (2014). https://doi.org/10.1007/s00384-013-1808-4

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