Diverticulosis: Knowledge and challenges

Abstract

Diverticulosis of the colon is a disease that was mentioned as far back as the 19th century, although it had no clinical significance at the time. The exact incidence of this disease is not known, but it is known that in the last 75 years it has occurred much more often. It is assumed that the more frequent occurrence of the disease is practically a reflection of better and more accessible diagnostic modalities, but also of lifestyle changes. Improper diet is one of the public health problems of the 21st century. A significant part of the global population eats unhealthy food and does not consume adequate amounts of fruits, vegetables, and fiber-rich foods in their daily diet. If we also add a sedentary lifestyle to the inadequate diet, the higher incidence of diverticulosis today is very much justified. Also, numerous studies have shown that relevant risk factors are smoking and frequent consumption of alcoholic drinks. Diet, medications, smoking, alcohol and stress are the most common risk factors that can lead to sac-like enlargements on the hollow organs, though predominantly on the large intestine. Due to the histological structure, diverticulum is most often expected to appear on the sigmoid colon. The appearance of one or more diverticulum along the colon or only one of its segments is called colonic diverticulosis. There is nothing in colonic diverticulosis that is pathognomonic for this disease, no particular signs and symptoms that would lead us, in clinical practice, to make the correct diagnosis without performing additional diagnostic assays. Establishing the correct diagnosis requires that we are familiar with the disease, that we ponder over it, that we know the broad spectrum of symptomatology, and that we know diagnostic procedures that can benefit the patient. Upon establishing the correct diagnosis, it is important to determine the clinical course, but also the form of the disease, so that we can determine an adequate treatment approach. In addition to changing the dietary habits, educating the patient about healthy lifestyles, it would be valuable to know which patient will benefit from the treatment with antibiotics, and which patient will require prompt surgical intervention