Clinical Health Updates

Benign course for symptomatic uncomplicated diverticular disease

Clinical Question:
What is the prognosis for adults with symptomatic uncomplicated diverticular disease?

Bottom Line:
The vast majority (more than 95%) of adults diagnosed with symptomatic uncomplicated diverticular disease described their symptoms as none or mild and as not affecting their daily activities after a 5-year follow-up.

Reference:
Salem TA, Molloy RG, O’Dwyer PJ. Prospective, five-year follow-up study of patients with symptomatic uncomplicated diverticular disease. Dis Colon Rectum 2007;50(9):1460-1464.

Study Design:
Cohort (prospective)

Synopsis:
To evaluate the natural history of diverticular disease, these investigators identified 163 adults, aged 64 to 80 years, diagnosed with symptomatic, uncomplicated diverticular disease. All patients were referred to a surgical outpatient clinic by their primary care clinician for the assessment of large bowel symptoms. Symptoms included lower left quadrant pain and/or change in bowel habits without evidence of inflammation (no fever, tenderness, or increased inflammatory markers). The diagnosis of diverticular disease was confirmed using colonoscopy, flexible sigmoidoscopy, or barium enema. Outcomes were assessed using a computerized database of hospital records, telephone contact with patients, and from primary care clinicians. A total of 25 patients were excluded from follow-up as a result of having left-sided colon cancer or rectal bleeding secondary to polyps or hemorrhoids. Nineteen patients died; none of the deaths were considered secondary to diverticular disease and an additional 18 patients (14%) were lost to follow-up. Of the remaining 119 patients who were followed up for a median of 5.5 years, 2 (1.7%) were successfully treated for acute diverticulitis and 1 additional patient underwent surgery for recurrent symptoms. The other 116 patients (97%) described their symptoms as either none or mild and as not affecting their daily activities after a median follow-up of 66 months.