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The mystery of diverticulitis: why is this condition so common in Western countries?
Diverticulitis, also known as colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal sacs (diverticula) in the walls of the large intestine. Symptoms of the disease often include sudden onset of lower abdominal pain, which may be accompanied by nausea, diarrhea, or constipation. Some patients may even develop fever or bloody stools, which are hints at possible complications. The causes of diverticulitis are not fully understood, but risk factors include obesity, lack of exercise, smoking and family history.
Having diverticula without inflammation is called diverticulosis. According to research, about 10% to 25% of patients will experience diverticulitis at some point, and this inflammation is often related to bacterial infection.
Unlike the low incidence in non-Western countries, diverticulitis is common in the Western world, with approximately 35% of the population having diverticular disease, while in rural areas of Africa, this proportion is less than 1%. In North America and Europe, abdominal pain is usually localized in the left lower abdomen (sigmoid colon), while in Asia it is more common in the right side (ascending colon). As age increases, the incidence of diverticulitis gradually increases, reaching 50% of patients in the age group over 60 years old.
Symptoms and complications
Symptoms of diverticulitis include sudden pain in the lower abdomen. Patients often have elevated C-reactive protein and increased white blood cell counts. In terms of complications, if the diverticulum becomes excessively inflamed and ruptures, bacteria can infect the abdominal cavity and cause peritonitis.
In some cases, diverticula may cause narrowing of the intestines, causing obstructions, or adhesions to the bladder or other pelvic organs to form fistulas.
Potential causes of diverticulitis are related to various factors such as age, diet, intestinal microbiome, genetic factors, intestinal motility and structural changes. Still, the exact cause remains unclear so far.
Incidence and risk factors
According to a 2021 study, about 50% of the risk of diverticulitis is related to genetic factors. Other influencing factors include obesity, cardiovascular disease and low vitamin D levels. In addition, physicians note that frequent bowel movements appear to increase the risk of recurrence.
Dietary studies suggest a possible link between a low-fiber diet and diverticulitis, but there is no conclusive evidence.
On the contrary, a healthy lifestyle, such as limiting red meat and high-fat dairy products, increasing fiber intake and engaging in regular exercise, can naturally reduce the risk of diverticulitis.
Diagnostic methods
Diagnosis of diverticulitis usually relies on computed tomography (CT scan), which may be supplemented by blood tests or endoscopy. CT images can show local thickening of the intestinal wall and inflammation of surrounding fat.
The incidence of cancer is less than 1% in patients with acute diverticulitis.
Prevention and treatment
If a patient has mild diverticulitis, the doctor may recommend oral antibiotics and a liquid diet. In severe cases, intravenous antibiotics, hospitalization, and complete intestinal rest may be required. In some cases, surgical intervention of the intestine is necessary.
Although research on probiotics is inconsistent, increasing fiber intake, reducing obesity, and staying physically active may help reduce the risk of diverticulitis.
Conclusion
The high incidence of diverticulitis throughout Western countries undoubtedly raises the question: What factors in modern life contribute to the prevalence of this disease?
