Role of Inflammation in the Pathogenesis of Diverticular Disease

Abstract

Diverticulosis of the colon is the most common condition in Western societies and it is the most common anatomic alteration of the human colon. Recurrent abdominal pain is experienced by about 20% of patients with diverticulosis, but the pathophysiologic mechanisms of its occurrence are not completely understood. In the last years, several fine papers have showed clearly the role of low-grade inflammation both in the occurrence of symptoms in people having diverticulosis, both in symptom persistence following acute diverticulitis, even if the evidence available is not so strong. We do not know yet what the trigger of this low-grade inflammation occurrence is. However, some preliminary evidence found colonic dysbiosis linked to low-grade inflammation and therefore to symptom occurrence in those patients. The aim of this paper is to summarize current evidences about the role of inflammation in symptom occurrence in symptomatic uncomplicated diverticular disease and in symptom persistence after an episode of acute diverticulitis.

The natural history of symptomatic uncomplicated diverticular disease: a long-term follow-up study

“…This behavior is similar to acute diverticulitis, in which the majority of recurrences are recorded during the first 2 years after the first episode of acute diverticulitis [ 20 ]. A possible explanation is that low-grade inflammation may play a role either in SUDD or in acute diverticulitis [ 21 ].…”

A Rare Case of Acute Urinary Bladder Diverticulitis Mimicking Acute Appendicitis

“…A few pathology papers have described a significant proportion of nonneoplastic urinary bladder diver-ticula having inflammatory changes [ 9 – 11 ]; however, as these were either postbiopsy or resected samples, it was difficult to determine if such inflammatory changes were directly involved in diverticulum formation or were the result of stasis of urine and the underlying clinical condition leading to the biopsy and resection. Previous papers looking at colonic diver-ticula disease found no signs of inflammatory change in histological samples [ 12 – 14 ]. While the colon and urinary bladder are different organs with functionally different processes and contents, it would not be wrong to postulate the limited role inflammation has in causing urinary bladder diverticula to form.…”

Application of Real-World Data and the REWARD Framework to Detect Unknown Benefits of Memantine and Identify Potential Disease Targets for New NMDA Receptor Antagonists

“…However, a randomized clinical trial found no effect of memantine on outcomes related to MS disease severity compared with placebo [ 42 ]. The observed potential benefit of memantine on diverticulosis could be due to its neuroprotective effects, decreasing the neural damage and regeneration that is observed in subjects with diverticular disease [ 43 , 44 ].…”