Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker 3.8)
Index Copernicus  – 171.00; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2011, vol. 20, nr 5, September-October, p. 623–626

Publication type: original article

Language: English

Colonic Diverticulosis and Risk of Large Bowel Adenomas

Uchyłkowatość jelita grubego a ryzyko występowania gruczolaków jelita grubego

Katarzyna Neubauer1,, Robert Dudkowiak2,, Radosław Kempiński1,, Adam Bąk3,, Leszek Paradowski1,

1 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

2 Dietetics Division at Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

3 resident on gastroenterology in the Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

Abstract

Background. The problem of the colonic diverticulosis, one of the most common diseases of the large bowel, as a risk factor for colonic adenomas and adenocarcinomas has not been fully clarified. The published results of the studies regarding this problem are contradictory.
Objectives. Evaluating the relationship between colonic diverticulosis and colonic adenomas.
Material and Methods. The group studied consisted of 3011 consecutive patients (1776 women, 1235 men, age 17–100 years, mean age 52.50 ± 16.36) which had endoscopic examination of the large bowel in the Endoscopy unit of the Department of Gastroenterology and Hepatology, Wroclaw Medical University. Retrospective analysis encompassed age, gender, presence and location of diverticula and presence and location of adenomas and adenocarcinomas.
Results. Diverticula were found in 425 patients (14.11%). Adenomas were found in 65 (15.3%) patients with diverticulosis and 190 (7.3%) patients without diverticulosis (OR = 2.28). Left-sided adenomas were found in 44 (10.35%) patients with left-sided diverticula and in 127 (4.9%) patients without diverticulosis (OR = 2.4). Colorectal cancer was present in 2.82% (n = 12) of patients with diverticulosis and in 3.79% (n = 98) of patients without diverticulosis. The presence of adenomas in relation to the presence of diverticula was statistically significant (chi-square analysis; p < 0.001). The presence of colorectal cancer in relation to the presence of diverticula was not statistically significant (p = 0.219).
Conclusion. The results of our study suggest that the presence of left-sided colonic diverticula may be considered as a risk factor for colonic adenomas.

Streszczenie

Wprowadzenie. Nie wyjaśniono jednoznacznie, czy uchyłkowatość jelita grubego, jedna z najczęstszych chorób okrężnicy, stanowi czynnik ryzyka rozwoju gruczolaków jelita grubego. Opublikowane wyniki badań poświęconych temu problemowi są sprzeczne.
Cel pracy. Ocena związku między uchyłkami i gruczolakami jelita grubego.
Materiał i metody. Grupę badaną tworzyło 3011 kolejnych pacjentów (1776 kobiet, 1235 mężczyzn, w wieku 17–100 lat, średni wiek 52,50 ± 16,36), u których przeprowadzono badanie endoskopowe jelita grubego w pracowni endoskopowej Kliniki Gastroenterologii i Hepatologii AM we Wrocławiu. W retrospektywnej analizie oceniano: wiek, płeć, obecność i umiejscowienie uchyłków, obecność i umiejscowienie gruczolaków i gruczolakoraków.
Wyniki. Uchyłki stwierdzono u 425 (14,11%) pacjentów, a gruczolaki – u 44 (10,7%) pacjentów z uchyłkowatością i 127 (4,9%) pacjentów bez uchyłkowatości. Raka jelita grubego rozpoznano u 2,82 (n = 12) pacjentów z uchyłkowatością i 3,79% (n = 98) pacjentów bez uchyłkowatości. Obecność gruczolaków w zależności od obecności uchyłków była istotna statystycznie (test c2; p < 0,001). Obecność raka jelita grubego w zależności od występowania uchyłków nie była istotna statystycznie (p = 0,219).
Wnioski. Wyniki badania własnego sugerują, że uchyłki w lewej połowie jelita grubego mogą być uważane za czynnik ryzyka gruczolaków jelita grubego.

Key words

colonic diverticulosis, colonic adenomas

Słowa kluczowe

uchyłkowatość jelita grubego, gruczolaki jelita grubego

References (20)

  1. Painter NS, Burkitt DP: Diverticular disease of the colon: a deficiency disease of Western civilization. Br Med J 1971, 2, 450–454.
  2. Tan KY, Seow-Chowen F: Fiber and colorectal diseases: separating fact from fiction. World J Gastroenterol 2007, 13, 4161–4167.
  3. Błachut K, Paradowski L, Garcarek J: Prevalence and distribution of the colonic diverticulosis. Review of 417 cases from Lower Silesia in Poland. Rom J Gastroenterol 2004, 13, 281–285.
  4. Neubauer K, Dudkowiak R, Paradowski L: Left-sided diverticulosis of the large bowel as the second most common abnormality in colonoscopy – review of 425 cases of colonic diverticulosis. Adv Clin Exp Med 2010, 19, 513–518.
  5. Parra-Blanco A: Colonic Diverticular Disease: Pathophysiology and Clinical Picture. Digestion 2006, Suppl. 1, 73, 47–57.
  6. Freeman HJ: Segmental colitis associated with diverticulosis syndrome. World J Gastroenterol 2008, 14, 6442– –6443.
  7. Wojciechowska U, Didkowska J, Zatoński W: Nowotwory złośliwe w Polsce w 2006 roku. Warszawa 2008.
  8. Morini S, Zullo A, Hassan C, Tomao S, MD, Campo S: Diverticulosis and Colorectal Cancer Between Lights and Shadows. J Clin Gastroenterol 2008, 42, 763–770.
  9. Krones CJ, Klinge U, Butz N, Junge K, Stumpf M, Rosch R, Hermanns B, Heussen N, Schumpelick V: The rare epidemiologic coincidence of diverticular disease and advanced colonic neoplasia. Int J Colorectal Dis 2006, 21, 18–24.
  10. Hirata T, Kawakami Y, Kinjo N, Arakaki S, Arakaki T, Hokama A, Kinjo F, Fujita A: Association between colonic polyps and diverticular disease World J Gastroenterol 2008, 14, 2411–2413.
  11. Meurs-Szojda MM, Terhaar JS, Kuik DJ, Mulder CJJ, Felt-Bersma RJF: Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies. Int J Colorectal Dis 2008, 23, 979–984.
  12. Kang HW, Kim D, Kim HJ, Kim CH, Kim YS, Park MJ, Kim JS, Cho SH, Sung MW, Jung HC, Lee HS, Song IS: Visceral obesity and insulin resistance as risk factors for colorectal adenoma: a cross-sectional, case-control study. Am J Gastroenterol 2010, 105, 178–187.
  13. Liu CS, Hsu HS, Li CI, Jan CI, Li TC, Lin WY, Lin T, Chen Y, Lee C, Lin C: Central obesity and atherogenic dyslipidemia in metabolic syndrome are associated with increased risk for colorectal adenoma in a Chinese population. BMC Gastroenterology 2010, 10, 51 doi: 10.1186/1471-230X-10-51.
  14. Kim K-S, Moon HJ, Choi Ch, Baek EK, Lee SY, Cha BK, Lee HW, Kim HJ, Do JH, Chang SK: The Frequency and Risk Factors of Colorectal Adenoma in Health-Check-up Subjects in South Korea: Relationship to Abdominal Obesity and Age. Gut and Liver 2010, 4, 2010, 36–42.
  15. Miller PE, Lesko SM, Muscat JE, Lazarus P, Hartman TJ: Dietary patterns and colorectal adenoma and cancer risk: a review of the epidemiological evidence. Nutr Cancer 2010, 62, 413–424.
  16. Manousos O, Day NE, Tzonou A, Papadimitriou C, Kapetanakis A, Polychronopoulou-Trichopoulou A, Trichopoulos D: Diet and other factors in the aetiology of diverticulosis: an epidemiological study in Greece. Gut 1985, 26, 544–549.
  17. Lin OS, Soon MS, Wu SS, Chen YY, Hwang KL, Triadafilopoulos G: Dietary habits and right-sided colonic diverticulosis. Dis Colon Rectum 2000, 43, 1412–1418.
  18. Aldoori WH, Giovannucci EL, Rimm EB, Wing AL, Trichopoulos DV, Willett WC: A prospective study of diet and the risk of symptomatic diverticular disease in men. Am J Clin Nutr 1994, 60, 757–764.
  19. Neubauer K: Overweight and obesity in patients with colonic diverticulosis. Gastroenterol Pol 2010, 17, 32–35.
  20. Commane DM, Arasaradman RP, Mills S, Mathers JC, Bradburn M: Diet, ageing and genetic factors in the pathogenesis of diverticular disease. World J Gastroenterol 2009, 15, 2479–2488.