An Analysis of the Development of Colonic Diverticulosis in the Japanese

Abstract

In contemporary Japanese, although the right predominated initially, diverticulosis showed a strong tendency to increase and spread from the right to the bilateral. The number of bilateral diverticula also tended to increase. The left did not change much.

Clinical Significance of Colonic Diverticulosis Associated with Bowel Symptoms and Colon Polyp

“…And these are being limited in the right colon and to relatively young patients, being mostly true diverticula or congenital, a single lesion or up to a few lesions, a low incidence rate and a low complication rate (4, 5, 11). The distinct characteristic of diverticulosis, that is different between the West and Asia, is the predominant proximal location of the colon in Asia.…”

“…The characteristics of diverticulosis are: the incidence is increased with age, the main lesion is generally located on the left colon, and the disease has a high complication rate (4). However, different characteristics of diverticulosis have been reported in Asian countries, such as its low incidence, main lesion generally limited to the right colon, a relatively small number of lesions, occurrence in young adults, and the lesions being mostly true diverticula (4). Nowadays, it seems that the adoption of a western lifestyle in Asian countries may result in a higher prevalence of diverticulosis (2).…”

Association between colonic polyps and diverticular disease

“…However, this result was similar to a previous study in Korea, in which patients with proximal diverticular disease had a higher risk of any proximal neoplasia than did other patients [30] . Diverticular disease of the proximal colon is rare in Western countries, whereas in Asia including Japan, diverticular disease of the proximal colon is relatively common [16,17,23,24] . These results suggest that, regardless of the segment with diverticular disease or race, patients with diverticular disease have a higher risk of colonic neoplasia.…”

“…There are differences between diverticular disease in Western countries and that seen in Asia, including Japan [15][16][17][18][19] . Diverticular disease of the right colon is rare in Western countries [20][21][22] , whereas in Asia, diverticular disease of the right colon is common and has been increasing in recent years [23][24][25][26][27] . This study evaluated the association between colonic polyps and diverticular disease in Japanese patients undergoing total colonoscopy.…”

Efficacy of 5-ASA in the Treatment of Colonic Diverticular Disease

“…Some authors also consider the diverticula located in the proximal colon of Asian patients as pseudodiverticula, [3][4][5] whereas other believe that they are true diverticula involving all layers of the colonic wall. 1,6,7 According to a recent report by the American Gastroenterological Association on the burden of digestive illnesses in the United States, 8 colonic diverticular disease represents, in terms of direct and indirect costs, the fifth most important gastrointestinal disease, with a mortality rate of 2.5/100,000/y. This condition may be asymptomatic (diverticulosis) or associated with ''symptoms,'' termed as diverticular disease, which may be uncomplicated [symptomatic uncomplicated diverticular disease (SUDD)] or complicated.…”