Bowel movement alterations predict the severity of diverticular disease and the risk of acute diverticulitis: a prospective, international study
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND/AIMS: Patients with diverticular disease (DD) frequently have abnormal bowel movements. However, it is unknown whether the entity of these alterations is associated with the severity of DD. We aimed to assess bowel habits and their relationship with the severity of DD according to Diverticular Inflammation and Complication Assessment (DICA) classification, Combined Overview on Diverticular Assessment (CODA) score, and fecal calprotectin (FC). METHODS: An international, multicenter, prospective cohort study was conducted in 43 centers. A 10-point visual analog scale (VAS) was used to assess the severity of constipation and diarrhea. The association of constipation and diarrhea with DICA classification, CODA score, and basal FC was tested using non-parametric tests. Survival methods for censored observations were applied to test the association of constipation and diarrhea with the incidence of acute diverticulitis over a 3-year follow-up. RESULTS: Of 871 patients with DD were included in the study. Of these, 208 (23.9%) and 199 (22.9%) reported a VAS score for constipation and diarrhea at least 3 at baseline, respectively. Higher constipation and diarrhea scores were associated with increasing DICA classification, CODA score and basal FC (P< 0.001). Constipation and diarrhea scores were independently associated with an increased hazard of developing acute diverticulitis (hazard ratio [HR]constipation = 1.15 per 1-VAS point increase, 95% confidence interval [CI], 1.04-1.27; P=0.004; and HRdiarrhea =1.14; 95% CI, 1.03-1.26; P=0.014, respectively). CONCLUSIONS: In newly diagnosed patients with DD, higher endoscopic and combined scores of DD severity were associated with higher scores of constipation and diarrhea at baseline. Both constipation and diarrhea were independent prognostic factors of acute diverticulitis.
Source: Intestinal Research
Authors: Antonio Tursi, Daniele Piovani, Giovanni Brandimarte, Francesco Di Mario, Walter Elisei, Marcello Picchio, Gisella Figlioli, Gabrio Bassotti, Leonardo Allegretta, Maria Laura Annunziata, Mauro Bafutto, Maria Antonia Bianco, Raffaele Colucci, Rita Conigliaro, Dan L. Dumitrascu, Ricardo Escalante, Luciano Ferrini, Giacomo Forti, Marilisa Franceschi, Maria Giovanna Graziani, Frank Lammert, Giovanni Latella, Daniele Lisi, Giovanni Maconi, Debora Compare, Gerardo Nardone, Lucia Camara de Castro Oliveira, Chaves Oliveira Enio, Savvas Papagrigoriadis, Anna Pietrzak, Stefano Pontone, Ieva Stundiene, Tomas Poškus, Giuseppe Pranzo, Matthias Christian Reichert, Stefano Rodino, Jaroslaw Regula, Giuseppe Scaccianoce, Franco Scaldaferri, Roberto Vassallo, Costantino Zampaletta, Angelo Zullo, Erasmo Spaziani, Stefanos Bonovas, Alfredo Papa, Silvio Danese, DICA International Group
Institutions: Università Cattolica del Sacro Cuore, Ospedale L. Bonomo, Humanitas University, IRCCS Humanitas Research Hospital, Ospedale Cristo Re, University of Parma, Azienda Ospedaliera San Camillo-Forlanini, University of Perugia, IRCCS Policlinico San Donato, Instituto de Gastroenterologia de Goiânia, Ospedale di Spoleto, Iuliu Hațieganu University of Medicine and Pharmacy, Universidad Central de Venezuela, Ospedale Santa Maria Goretti, Azienda Ospedaliera San Giovanni Addolorata, Medizinische Hochschule Hannover, Universitätsklinikum des Saarlandes, Saarland University, University of L'Aquila, San Salvatore Hospital, ASL Roma, University of Milan, Luigi Sacco Hospital, Federico II University Hospital, Universidade Federal de Goiás, King's College Hospital, The Maria Sklodowska-Curie National Research Institute of Oncology, Policlinico Umberto I, Sapienza University of Rome, Vilnius University, Azienda Ospedaliera Pugliese Ciaccio, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Buccheri la Ferla Fatebenefratelli, Azienda Sanitaria Locale Viterbo, Ospedale di Belcolle, Ospedale Regina Margherita, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4401523821