Symptomatic Diverticulosis Is Characterized By Loose Stools.Järbrink Sehgal ME, Andreasson A, Talley NJ, Agréus L, Song JY, Schmidt PT. Clin Gastroenterol Hepatol. 2016 Jun 21. [Epub ahead of print]

BACKGROUND & AIMS: Symptomatic uncomplicated diverticular disease is considered to be a discreet clinical entity distinct from irritable bowel syndrome (IBS), but population-based data are unavailable.

We aimed to investigate the prevalence and location of diverticulosis in the general population, and its association with colonic symptoms and mental health. We propose that individuals with diverticulosis would report more constipation and IBS.METHODS: We performed a population-based study of randomly select adults born in Sweden (18-70 years old, 57.2% women); 745 received a gastroenterology consultation, completed validated abdominal symptom and mental health questionnaires, and were examined by colonoscopy. Logistic regression was used to calculate the associations between diverticulosis and age, gender, gastrointestinal symptoms, anxiety, depression and self-rated health.RESULTS: Among the 742 participants (54.6% women) 130 (17.5%) had diverticulosis. Age was the strongest predictor of diverticulosis (P<.001) and diverticulosis was rare in participants younger than 40 years (0.7%). All participants with diverticulosis had sigmoid involvement. Participants with diverticulosis were more likely to report loose stools (odds ratio [OR], 1.88; 95% CI, 1.20-2.96), urgency (OR, 1.64; 95% CI, 1.02-2.63), passing mucus (OR, 2.26; 95% CI, 1.08-4.72), and a high stool frequency (OR, 2.02; 95% CI, 1.11-3.65). Diverticulosis was associated with abdominal pain (OR, 2.10; 95% CI, 1.01-4.36; P=.047) and IBS-diarrhea (OR, 9.55; 95% CI, 1.08-84.08; P=.04) in participants older than 60 years. Presence of anxiety and depression and self-rated health were similar in participants with and without diverticulosis.CONCLUSION: The prevalence of diverticulosis is age dependent. Diverticulosis is associated with diarrhea in subjects across all age ranges. In subjects older than sixty, diverticulosis is associated with abdominal pain and diarrhea-predominant IBS.

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