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A Hypothesis: Is Diverticulitis a Type of Inflammatory Bowel Disease?

Floch, Martin H. MD, MACG

Journal of Clinical Gastroenterology: August 2006 - Volume 40 - Issue - p S121-S125
doi: 10.1097/01.mcg.0000225502.29498.ba
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It is accepted by epidemiologists that diverticula formation in the colon is related to a deficiency in dietary fiber intake, but the cause of acute diverticulitis remains unknown. A hypothesis is presented that acknowledges from the literature that fiber deficiency is also related to an altered intestinal microecology with a change in the bacterial flora. It is hypothesized that the change in the flora with a decrease in their influence on the immune process permits a low-grade chronic inflammation in the mucosa, which is the first step in developing an acute infection of diverticula or diverticulitis. There is some evidence that the low-grade chronic inflammation is present in subjects with diverticula, which is the forerunner of acute diverticulitis. This hypothesis is strengthened by early reports that anti-inflammatory mucosal agents such as mesalamine and immune process regulators such as probiotics may improve diverticulitis.

Section of Digestive Disease, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT

© 2006 Lippincott Williams & Wilkins, Inc.