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Diverticular disease in younger patients--is it clinically more complicated and related to obesity?

S M Pilgrim1, A R Hart, C T M Speakman

  • 1Department of General Surgery, Norfolk & Norwich University Hospital, Norwich, UK.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|March 28, 2013
PubMed

Insights

Young patients presenting with lower abdominal pain are increasingly diagnosed with diverticular disease. Obesity is a significant factor in these cases, necessitating differential diagnosis with appendicitis.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology

Background:

  • Diverticular disease typically affects older populations.
  • Emerging evidence suggests an increase in diverticular disease among younger individuals.

Purpose of the Study:

  • To identify common presentations of diverticular disease in patients younger than 40.
  • To evaluate the role of obesity as a contributing factor in this demographic.

Main Methods:

  • A systematic review of original articles published between 1990 and 2011.
  • Searches were conducted in PubMed, EMBASE, and the Cochrane Library.
  • Inclusion criteria focused on diverticular disease, obesity (BMI ≥ 30 kg/m²), and patients under 40.

Main Results:

  • Twenty-five studies were identified, including case series and population-based studies.
  • Young patients presented more frequently with diverticular disease.
  • While less complicated, diverticular disease in this group had higher emergency operation rates.
  • A high prevalence of obesity (63.1-96.5%) was observed in young patients with diverticular disease.

Conclusions:

  • Diverticulitis should be considered in the differential diagnosis of lower abdominal pain in young, obese patients, alongside appendicitis.
  • Diagnostic imaging such as CT or laparoscopy is recommended when the diagnosis is uncertain.
Abstract

Keywords:
Youngdiverticular diseasediverticulitisobeseobesity

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