Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8320
Peer-review started: September 18, 2023
First decision: November 13, 2023
Revised: November 15, 2023
Accepted: December 4, 2023
Article in press: December 4, 2023
Published online: December 16, 2023
Processing time: 86 Days and 19.2 Hours
Diverticulosis coli is one of the leading causes of morbidity in Western countries. Abnormal colonic pressure profiles have been associated with an increased risk of colonic diverticulosis.
Despite its high prevalence, the pathogenesis of colonic diverticulosis remains poorly understood.
We sought to assess whether previous abdominal surgery, presumably by means of adhesion-related increased colonic intraluminal pressure, is associated with colonic diverticulosis or diverticulitis.
Patients undergoing colonoscopy completed a structured questionnaire concerning previous abdominal surgeries, dietary and lifestyle exposures including smoking and alcohol use, and co-morbidities. The presence of diverticulosis was identified via colonoscopy.
Three hundred and fifty-nine patients were included in the study. The overall prevalence of colonic diverticulosis was 25% (91/359) and 48% of the patients had previous abdominal surgery. There was no difference in the rate of previous abdominal surgery between patients with or without diverticulosis (49% vs 47%, P = 0.78). In regards to specific surgeries, inguinal hernia repair was significantly associated with diverticulosis (52% vs 20%, P = 0.001), but not diverticulitis. In contrast, appendectomy was not associated with diverticulosis (6% vs 14%, P = 0.048).
These findings suggest that post-operative abdominal adhesions inducing high colonic intraluminal pressures do not appear to be the mechanism for diverticula formation. Rather, inguinal hernia and diverticulosis may share similar connective tissue pathologies with no causative relationship between them.
The pathogenesis of colonic diverticulosis remains unclear and future studies are needed.