Diverticular disease of the large bowel in Singapore

Abstract

One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P less than 0.01) and Indian men (P less than 0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore-born and foreign-born Singaporeans. The cause of right-sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticula examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.

Diet, ageing and genetic factors in the pathogenesis of diverticular disease

“…This study showed no difference in DD incidence between first and second generation Asians although numbers were limited [15] . In addition, an autopsy-based study of 1014 cadavers in Singapore showed a significantly higher risk of DD amongst the ethnically Chinese population when compared to the ethnically Malay and Indian populations [16] . The epidemiological data described suggests environmental and genetic components to DD etiology.…”

Association between colonic polyps and diverticular disease

“…Although some data have been reported regarding the association between these diseases in Western countries [11][12][13][14] , there has been no study in Japan. 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] .…”

Epidemiological Evaluation of Colonic Diverticulosis and Dietary Fiber in Japan

“…The diverticulosis is rare in Africa (Cambell 1967;Archampomg et al 1978), Asia (Kang et al 1975;Vajrabukka et al 1980;Munakata et al 1982;Pan et al 1985;Lee 1986), and many parts of South America. The residents of these areas subsist on diet high in vegetable fiber content and low in refined carbohydrate; for the denizens of Western cities the reverse is true.…”