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The prevalence of right-sided colonic diverticulosis and diverticular haemorrhage
J-L Faucheron1, X Roblin, P Bichard
1Department of Surgery, University Hospital, Grenoble, France. jlfaucheron@chu-grenoble.fr
Insights
Right-sided diverticular disease is common in Western populations and significantly increases the risk of bleeding, independent of patient age. This finding highlights the importance of considering diverticulosis location in clinical assessments.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Epidemiology
Background:
- Diverticular disease is prevalent in Western populations, with prevalence increasing with age.
- The location of diverticula (right vs. left) and its association with bleeding risk are not well-established.
Purpose of the Study:
- To determine the prevalence of right-sided diverticular disease in a Western population.
- To investigate whether right-sided diverticular disease poses a higher bleeding risk compared to left-sided disease.
Main Methods:
- A prospective colonoscopy study of 796 consecutive patients was conducted between January 2004 and June 2005.
- Data on patient demographics and diverticula presence/location were collected.
- A comparison cohort of 133 patients admitted for colonic diverticular bleeding was analyzed.
Main Results:
- 40% of patients had noncomplicated diverticulosis, with 32.4% of these cases involving right-sided diverticula.
- Right diverticula were found in 65.2% of patients with diverticular bleeding versus 32.4% without bleeding (P=0.0001).
- Right-sided diverticulosis independently increased bleeding risk (OR=3.6, P=0.0001), irrespective of patient age.
Conclusions:
- Prevalence of colonic diverticula rises significantly with age, affecting up to 75% of individuals over 75.
- Nearly one-third of patients with diverticulosis exhibit right-sided involvement.
- Right-sided diverticular disease is a significant independent risk factor for colonic bleeding.
Aim:
The study was performed to determine the prevalence of right-sided diverticular disease in a western population and whether it is more likely to bleed than disease on the left side.
Method:
From January 2004 to June 2005, 796 consecutive patients were referred for total colonoscopy to 17 physicians. Data obtained included age, gender, and presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding.
Results:
Three-hundred and eighteen (40%) of the 796 patients presented with noncomplicated diverticulosis. Of these, 103 (32.4%) had right-sided diverticula. In univariate analysis, the presence of right diverticula in patients admitted for diverticular bleeding was about twice as frequent as in patients who had diverticula with no bleeding (65.2% vs 32.4%; P = 0.0001). In multivariate analysis, the right localization of the diverticulosis was associated with a risk of bleeding, which was independent of the patients' age (P = 0.0001, OR = 3.6).
Conclusion:
The prevalence of colonic diverticula increased from < 10% in adults under 40 years of age to about 75% in those over 75 years of age. Of these patients, nearly one-third presented with right-sided involvement. Right-sided localization was associated with a significant risk of bleeding, which was independent of the patients' age.
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