Chronic constipation is negatively associated with colonic diverticula

Abstract

Objectives: Constipation has been considered the key risk factor for diverticulosis occurrence, although the underlying mechanism is unclear. We investigated the factors associated with diverticulosis, focusing on the association of constipation severity with the localization and number of diverticula. Materials and methods:We analyzed consecutive patients who underwent colonoscopy between March and December 2019. Chronic constipation was diagnosed as constipation meeting Rome Ⅳ criteria or as that requiring laxative therapy for more than six months. The degree of constipation was scored using the constipation scoring system (CSS). Results:We assessed 1014 patients. Multivariate analysis revealed that age, alcohol consumption, and hypertension were positively associated with diverticulosis, whereas chronic constipation was negatively associated with diverticulosis (Odds ratio[OR]=0.74, 95% confidence interval [CI] 0.55-0.99). When assessed according to the location of diverticula, right-sided diverticula were significantly associated with a lower incidence of constipation (OR=0.94; 95% CI 0.89-0.98), while neither left-sided nor bilateral diverticula was associated with constipation. This negative association of diverticula with constipation was stronger in patients with high CSS score. In stratified analysis, the number of diverticula decreased with increasing degree of constipation (p for trend <0.01) and a high CSS score was associated with a decreased prevalence of ≧ 3 diverticula (OR=0.64, 95% CI, 0.44-0.99).Conclusions: Chronic constipation was negatively associated with colonic diverticulosis. The association increased with the degree of constipation and was strong only in cases with right-sided diverticula and those with ≧3 diverticula.

Colonic Diverticulosis Is Not Associated With Painful Abdominal Symptoms in a US Population

“…Contrary to these beliefs, recent cross-sectional studies have found that constipation and a low-fiber diet were not associated with diverticulosis. 23 – 25 A cross-sectional study also found no association between diverticulosis and straining or incomplete bowel movements. 24 Instead, individuals with more frequent bowel movements were more likely to have diverticulosis.…”

Efficacy and tolerability of 1 L polyethylene glycol plus ascorbic acid with senna versus 2 L polyethylene glycol plus ascorbic acid for colonoscopic bowel preparation: Prospective, randomized, investigator‐blinded trial

“…Demographic and comorbidity data were obtained using a questionnaire. Chronic constipation was diagnosed based on Rome IV criteria for functional constipation 36 . The severity of constipation was measured using the Constipation Scoring System (CSS; range 0–30) 37 .…”

“…Chronic constipation was diagnosed based on Rome IV criteria for functional constipation. 36 The severity of constipation was measured using the Constipation Scoring System (CSS; range 0-30). 37 In another questionnaire, data concerning colonoscopy and BP were obtained on the day of colonoscopy.…”