Skip to main content

Advertisement

Springer Nature Link
Log in

Diverticular Disease in the Elderly

  • Gastroenterology in Geriatric Patients (S Chokhavatia, Section Editor)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

While few diseases are limited solely to the elderly, diverticular disease is clearly more prevalent with increasing age and therefore the aim of this review is to focus on the clinical implications of diverticular disease in the elderly.

Recent Findings

Diverticulitis in the elderly is best managed with an individualized treatment approach including considerations for selective antibiotic usage even in uncomplicated disease. Furthermore, due to the increased prevalence of ischemic colitis in the elderly and the similarities in presentation with diverticular hemorrhage, there needs to be a high index of suspicion and appropriate evaluation for ischemic colitis in patients with hematochezia, particularly if they have abdominal pain.

Summary

The elderly are a vulnerable population where the index of suspicion for complications of diverticular disease should be high.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Image 1.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Stollman NH, Raskin JB. Diagnosis and management of diverticular disease of the colon in adults. Ad hoc practice parameters committee of the American College of Gastroenterology. Am J Gastroenterol. 1999;94:3110–21.

    CAS  PubMed  Google Scholar 

  2. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology. 2009;136:741–54.

    PubMed  Google Scholar 

  3. •• Peery AF, Crockett SD, Murphy CC, et al. Burden of gastrointestinal, liver, and pancreatic diseases in the United States. Gastroenterology. 2019;156:254–72 Updated report of the financial and economic burden of diverticular disease.

    PubMed  Google Scholar 

  4. Boynton W, Floch M. New strategies for the management of diverticular disease: insights for the clinician. Therapeut Adv Gastroenterol. 2013;6(3):205–13.

    Google Scholar 

  5. Peery AF, Barrett PR, Park D, Rogers AJ, Galanko JA, Martin CF, et al. A high-fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology. 2012;142:266–72.

    PubMed  Google Scholar 

  6. Jarbrink-Sehgal ME, Andreasson A, Talley NJ, et al. Symptomatic diverticulosis is characterized by loose stools. Clin Gastroenterol Hepatol. 2016;14:1763–70.e1.

    PubMed  Google Scholar 

  7. Strate LL, Modi R, Cohen E, Spiegel BMR. Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights. Am J Gastroenterol. 2012;107:1486–93.

    PubMed  Google Scholar 

  8. Shahedi K, Fuller G, Bolus R, Cohen E, Vu M, Shah R, et al. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clin Gastroenterol Hepatol. 2013;11:1609–13.

    PubMed  PubMed Central  Google Scholar 

  9. Ambrosetti P, Chautems R, Soravia C, Peiris-Waser N, Terrier F. Long-term outcome of mesocolic and pelvic diverticular abscesses of the left colon: a prospective study of 73 cases. Dis Colon Rectum. 2005;48:787–91.

    PubMed  Google Scholar 

  10. Comparato G, Pilotto A, Franze A, et al. Diverticular disease in the elderly. Dig Dis. 2007;25:151–9.

    PubMed  Google Scholar 

  11. Burkitt DP. Epidemiology of cancer of the colon and rectum. Cancer. 1971;28:3–13.

    CAS  PubMed  Google Scholar 

  12. Burkitt DP. Cancer of the GI tract: colon, rectum, anus. Epidemiology and etiology. JAMA. 1975;231(5):517–8.

    CAS  PubMed  Google Scholar 

  13. Peery AF, Sandler RS, Ahmen DJ, et al. Constipation and a low-fiber diet are not associated with diverticulosis. Clin Gastroenterol Hepatol. 2013;11:1622–7.

    PubMed  Google Scholar 

  14. Jun S, Stollman N. Epidemiology of diverticular disease. Best Pract Res Clin Gastroenterol. 2002;16(4):529–42.

    PubMed  Google Scholar 

  15. Chan CC, Lo KKL, Chung ECH, et al. Colonic diverticulosis in Hong Kong: distribution patter and clinical significance. Clin Radiol. 1998;53(11):842–4.

    CAS  PubMed  Google Scholar 

  16. Rajendra S, Ho JJ. Colonic diverticular disease in a multiracial Asian patient population has an ethnic predilection. Eur J Gastroenterol Hepatol. 2005;17:871–5.

    PubMed  Google Scholar 

  17. Granlund J, Svensson T, Olen O, et al. The genetic influence on diverticular disease: a twin study. Aliment Pharmacol Ther. 2012;35:1103–7.

    CAS  PubMed  Google Scholar 

  18. • Strate LL, Erichsen R, Baron JA, et al. Heritability and familial aggregation of diverticular disease: a population-based study of twins and siblings. Gastroenterology. 2013;144:736–742.e1 One of the significant studies suggesting a familial and genetic basis to diverticular disease.

    PubMed  Google Scholar 

  19. Connelly TM, Berg AS, Hagerty JP, et al. The TNFSF15 gene single nucleotide polymorphism rs7848647 is associated with surgical diverticulitis. Ann Surg. 2014;259(6):1132–7.

    PubMed  Google Scholar 

  20. Painter NS. The cause of diverticular disease of the colon, its symptoms and its complications: review and hypothesis. J R Coll Surg Edinb. 1985;30:118–22.

    CAS  PubMed  Google Scholar 

  21. Aldoori WH, Giovannucci EL, Rockett HR, et al. A prospective study of dietary fiber types and symptomatic diverticular disease in men. J Nutr. 1998;128:714–9.

    CAS  PubMed  Google Scholar 

  22. Crowe FL, Appleby PN, Allen NE, Key TJ. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ. 2011;343:d4131.

    PubMed  PubMed Central  Google Scholar 

  23. Crowe FL, Balkwill A, Cairns BJ, Appleby PN, Green J, Reeves GK, et al. Source of dietary fibre and diverticular disease incidence: a prospective study of UK women. Gut. 2014;63:1450–6.

    PubMed  PubMed Central  Google Scholar 

  24. • Stollman N, Smalley W, Hirano I, et al. American gastroenterological association institute guideline on the management of acute diverticulitis. Gastroenterology. 2015;149:1944–9 The most recent AGA guidelines addressing several important considerations regarding management of acute diverticulitis.

    PubMed  Google Scholar 

  25. Barbara G, Scaioli E, Barbaro MR, Biagi E, Laghi L, Cremon C, et al. Gut microbiota, metabolome and immune signatures in patients with uncomplicated diverticular disease. Gut. 2017;66:1252–61.

    CAS  PubMed  Google Scholar 

  26. Rajilic-Stojanovic M, Biagi E, Heilig HG, et al. Global and deep molecular analysis of microbiota signatures in fecal samples from patients with irritable bowel syndrome. Gastoenterology. 2011;141:1792–801.

    CAS  Google Scholar 

  27. Dicksved J, Halfvarson J, Rosenquist M, Järnerot G, Tysk C, Apajalahti J, et al. Molecular analysis of the gut microbiota of identical twins with Crohn’s disease. ISME J. 2008;2:716–27.

    CAS  PubMed  Google Scholar 

  28. Spiller R. How inflammation changes neuromuscular function and its relevance to symptoms of diverticular disease. J Clin Gastroenterol. 2006;40(Suppl 3):S117–20.

    PubMed  Google Scholar 

  29. Humes DJ, Simpson J, Smith J, Sutton P, Zaitoun A, Bush D, et al. Visceral hypersensitivity in symptomatic diverticular disease and the role of neuropeptides and low grade inflammation. Neurogastroenterol Motil. 2012;24:318–e163.

    CAS  PubMed  Google Scholar 

  30. Horgan AF, McConnel EJ, Wolff BG, et al. Atypical diverticular disease: surgical results. Dis Colon Rectum. 2001;44:1315–8.

    CAS  PubMed  Google Scholar 

  31. Bottner M, Wedel T. Abnormalities of neuromuscular anatomy in diverticular disease. Dig Dis. 2012;30:19–23.

    PubMed  Google Scholar 

  32. Golder M, Burleigh DE, Belai A, Ghali L, Ashby D, Lunniss PJ, et al. Smooth muscle cholinergic denervation hypersensitivity in diverticular disease. Lancet. 2003;361:1945–51.

    CAS  PubMed  Google Scholar 

  33. Peery AF, Keku TO, Addamo C, et al. Colonic diverticula are not associated with mucosal inflammation or chronic gastrointestinal symptoms. Clin Gastroenterol Hepatol. 2018;16:884–91 E1.

    PubMed  Google Scholar 

  34. Bassotti G, Villanacci V, Bernardini N, Dore MP. Diverticular disease of the colon neuromuscular function abnormalities. J Clin Gastroenterol. 2016;50(Suppl 1):S6–8.

    PubMed  Google Scholar 

  35. Dai L, King DW, Perera DS, Lubowski DZ, Burcher E, Liu L. Inverse expression of prostaglandin E2-related enzymes highlights differences between diverticulitis and inflammatory bowel disease. Dig Dis Sci. 2015;60(5):1236–46.

    CAS  PubMed  Google Scholar 

  36. Goldstein NS, Admad E. Histology of the mucosa in sigmoid colon specimens with diverticular disease: observations for the interpretation of sigmoid colonoscopic biopsy specimens. Am J Clin Pathol. 1997;107:438–44.

    CAS  PubMed  Google Scholar 

  37. Tursi A, Elisei W. Role of inflammation in the pathogenesis of diverticular disease. Mediat Inflamm. 2019;14:1–7.

    Google Scholar 

  38. Rustom LBO, Sharara AI. The natural history of colonic diverticulosis: much ado about nothing? Inflamm Intes Dis. 2018;3:69–74.

    Google Scholar 

  39. Niikura R, Nagata N, Shimbo T, et al. Natural history of bleeding risk in colonic diverticulosis patients: a long-term colonoscopy-based cohort study. Aliment Pharmacol Ther. 2015;4:888–94.

    Google Scholar 

  40. Shayto R, Hanna K, Ziyade N, Chehab H, Chalhoub JM, Harb AH, et al. The natural history of incidental colonic diverticulosis on screening colonoscopy: a prospective cohort study. Gastroenterology. 2016;150:S308.

    Google Scholar 

  41. McConnel EJ, Tessier DJ, Wolff BG. Population-based incidence of complicated diverticular disease of the sigmoid colon based on gender and age. Dis Colon Rectum. 2003;46(8):1110–4.

    Google Scholar 

  42. Mosadeghi S, Bhuket T, Stollman N. Diverticular disease: evolving concepts in classification, presentation and management. Curr Opin Gastroenterol. 2015;31:50–5.

    CAS  PubMed  Google Scholar 

  43. • Strate LL, Morris AM. Epidemiology, pathophysiology and treatment of diverticulitis. Gastroenterol. 2019;156:1282–98 Most recent thorough review article with clinical assessment algorithm for diverticulitis.

    Google Scholar 

  44. Narayan R, Floch MH. Microscopic colitis as part of the natural history of diverticular disease. Am J Gastroenterol. 2002;97(9):S112–3.

    Google Scholar 

  45. • Peery A, Stollman N. Antibiotics for acute uncomplicated diverticulitis: time for a paradigm change? Gastroenterology. 2015;149:1650–1 Concise overview of the shift in antibiotic usage including use in immunocompromised population.

    PubMed  PubMed Central  Google Scholar 

  46. Feuerstein JD, Falchuk KR. Diverticulosis and diverticulitis. Mayo Clin Proc. 2016;91(18):1094–104.

    PubMed  Google Scholar 

  47. Halligan S, Saunders B. Imaging diverticular disease. Best Pract Res Clin Gastroenterol. 2002;16(4):595–610.

    PubMed  Google Scholar 

  48. Adams JT. Therapeutic barium enema for massive diverticular bleeding. Arch Surg. 1970;101:457–60.

    CAS  PubMed  Google Scholar 

  49. Miller RE, Skucas J, Violante MR, Shapiro ME. The effect of barium on blood in the gastrointestinal tract. Radiology. 1975;117:527–30.

    CAS  PubMed  Google Scholar 

  50. Matsuura M, Inamori M, Nakajima A, Komiya Y, Inoh Y, Kawasima K, et al. Effectiveness of therapeutic barium enema for diverticular hemorrhage. World J Gastroenterol. 2015;21(18):5555–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Biondo S, Lopez Borao J, Millan M, Kreisler E, Jaurrieta E. Current status of the treatment of acute colonic diverticulitis: a systematic review. Color Dis. 2012;14(1):e1–e11.

    CAS  Google Scholar 

  52. •• Flor N, Maconi G, Cornalba G, Pickhardt PJ. The current role of radiologic and endoscopic imaging in the diagnosis and follow-up of colonic diverticular disease. AJR Am J Roentgenol. 2016;207(1):15–24 A detailed paper outlining the role of various radiographic studies in the evaluation of diverticular disease.

    PubMed  Google Scholar 

  53. Lameris W, Van Randen A, Bipat S, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. 2008;18:2498–511.

    PubMed  Google Scholar 

  54. Liljegren G, Chabok A, Wickbom M, Smedh K, Nilsson K. Acute colonic diverticulitis: a systematic review of diagnostic accuracy. Color Dis. 2007;9:480–8.

    CAS  Google Scholar 

  55. Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg. 1978;12:85–109.

    CAS  PubMed  Google Scholar 

  56. Ambrosetti P. Acute left-sided colonic diverticulitis: clinical expressions, therapeutic insights, and role of computed tomography. Clin Exp Gastroenterol. 2016;9:249–57.

    PubMed  PubMed Central  Google Scholar 

  57. Mora Lopez L, Serra Pla S, Serra-Aracil X, Ballesteros E, Navarro S. Application of a modified Neff classification to patients with uncomplicated diverticulitis. Color Dis. 2013;15:1442–7.

    CAS  Google Scholar 

  58. Buckley O, Geoghegan T, O’Riordain DS, et al. Computed tomography in the imaging of colonic diverticulitis. Clin Radiol. 2004;59(11):977–83.

    CAS  PubMed  Google Scholar 

  59. Sharma PV, Eglinton T, Hider P, Frizelle F. Systematic review and meta-analysis of the role of routine colonic evaluation after radiologically confirmed acute diverticulitis. Ann Surg. 2014;259:263–72.

    PubMed  Google Scholar 

  60. Daniels I, Unlu C, de Wijkerslooth TR, et al. Yield of colonoscopy after recent CT-proven uncomplicated acute diverticulitis: a comparative cohort study. Surg Endosc. 2015;29:2605–13.

    PubMed  Google Scholar 

  61. Lau KC, Spilsbury K, Faroque Y, et al. Is colonoscopy still mandatory after a CT diagnosis of left-sided diverticulitis: can colorectal cancer be confidently excluded? Dis Colon Rectum. 2011;54:1265–70.

    CAS  PubMed  Google Scholar 

  62. Cuomo R, Barbara G, Pace F, Annese V, Bassotti G, Binda GA, et al. Italian consensus conference for colonic diverticulosis and diverticular disease. United European Gastroenterol J. 2014;2:413–42.

    PubMed  PubMed Central  Google Scholar 

  63. Lahat A, Yanai H, Menachem Y, Avidan B, Bar-Meir S. The feasibility and risk of early colonoscopy in acute diverticulitis: a prospective controlled study. Endoscopy. 2007;39:521–4.

    CAS  PubMed  Google Scholar 

  64. Jensen DM, Machicado GA. Diagnosis and treatment of severe hematochezia: the role of urgent colonoscopy after purge. Gastroenterology. 1988;95:1569–74.

    CAS  PubMed  Google Scholar 

  65. Hizawa K, Miura N, Matsumoto T, Iida M. Colonic diverticular bleeding: precise localization and successful management by a combination of CT angiography and interventional radiology. Abdom Imaging. 2009;34:777–9.

    PubMed  Google Scholar 

  66. Loffroy R. Multidetector CT angiography for the detection of colonic diverticular bleeding: when, how, and why? Dig Dis Sci. 2013;58:1822–4.

    PubMed  Google Scholar 

  67. Nagata N, Niikura R, Aoki T, Moriyasu S, Sakurai T, Shimbo T, et al. Role of urgent contrast-enhanced multidetector computed tomography for acute lower gastrointestinal bleeding in patients undergoing early colonoscopy. J Gastroenterol. 2015;50:1162–72.

    PubMed  Google Scholar 

  68. Laing CJ, Tobias T, Rsenblum DI, et al. Acute gastrointestinal bleeding: emerging role of multi detector CT angiography and review of current imaging techniques. RadioGraphics. 2007;27:1055–70.

    PubMed  Google Scholar 

  69. Jacobs DO. Clinical practice: diverticulitis. N Engl J Med. 2007;357:2057–66.

    CAS  PubMed  Google Scholar 

  70. Chabok A, Pahlam L, Hjern F, AVOD study group, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012;99:532–9.

    CAS  PubMed  Google Scholar 

  71. Westwood DA, Eglinton TW. Antibiotics may not improve short-term or long-term outcomes in acute uncomplicated diverticulitis. Evid Based Med. 2013;18:32–3.

    PubMed  Google Scholar 

  72. Isacson D, Andreasson K, Nikberg M, Smedh K, Chabok A. No antibiotics in acute uncomplicated diverticulitis: does it work? Scand J Gastroenterol. 2014;49:1441–6.

    CAS  PubMed  Google Scholar 

  73. Daniels I, Unlu C, de Korte N, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg. 2017;104:52–61.

    CAS  PubMed  Google Scholar 

  74. Annibale B, Carabotti M, Cuomo R. Italian guidelines. J Clin Gastroenterol. 2016;50(Suppl 1):S44–6.

    PubMed  Google Scholar 

  75. Tursi A, Brandimarte G, Elisei W, Picchio M, Forti G, Pianese G, et al. Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease. A double-blind, randomized, placebo-controlled study. Aliment Pharmacol Ther. 2013;38:741–51.

    CAS  PubMed  Google Scholar 

  76. Raskin JB, Kamm MA, Jamal MM, Márquez J, Melzer E, Schoen RE, et al. Mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials. Gastroenterology. 2014;147:793–802.

    CAS  PubMed  Google Scholar 

  77. Khan MA, Ali B, Lee WM, Howden CW. Mesalamine does not help prevent recurrent acute colonic diverticulitis: meta-analysis of randomized, placebo-controlled trials. Am J Gastroenterol. 2016;111:579–81.

    PubMed  Google Scholar 

  78. Papi C, Ciaco A, Koch M, Capurso L. Efficacy of rifaximin in the treatment of symptomatic diverticular disease of the colon: a multicenter double-blind placebo-controlled trial. Aliment Pharmacol Ther. 1995;9:33–9.

    CAS  PubMed  Google Scholar 

  79. Latella G, Pimpo MT, Sottili S, Zippi M, Viscido A, Chiaramonte M, et al. Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon. Int J Color Dis. 2003;18:55–62.

    Google Scholar 

  80. Bianchi M, Festa V, Moretti A, Ciaco A, Mangone M, Tornatore V, et al. Meta-analysis: long-term therapy with rifaximin in the management of uncomplicated diverticular disease. Aliment Pharmacol Ther. 2011;33:902–10.

    CAS  PubMed  Google Scholar 

  81. Lahner E, Bellisario C, Hassan C, et al. Probiotics in the treatment of diverticular disease: a systematic review. J Gastrointestin Liver Dis. 2016;25:79–86.

    PubMed  Google Scholar 

  82. Rezapour M, Ali S, Stollman N. Diverticular disease: an update on pathogenesis and management. Gut Liver. 2018;12(2):125–32.

    CAS  PubMed  Google Scholar 

  83. Bhucket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt IJ, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease: pathophysiology, diagnosis, management, vol. 2. 10th ed. Philadelphia: Elsevier; 2014. p. 1–15.

    Google Scholar 

  84. • Feingold D, Steele SR, Lee S, et al. Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum. 2014;57:284–94 The American Society for Colon and Rectal Surgery recommendations on hospitalization, antibiotic use, and necessity of colonoscopy after an episode of diverticulitis.

    PubMed  Google Scholar 

  85. Klarenbleek BR, Samuels M, van der Wall MA, et al. Indications for elective sigmoid resection in diverticular disease. Ann Surg. 2010;251:670–4.

    Google Scholar 

  86. Lidor AO, Segal JB, Wu AW, Yu Q, Feinberg R, Schneider EB. Older patients with diverticulitis have low recurrence rates and rarely need surgery. Surgery. 2011;150:146–53.

    PubMed  Google Scholar 

  87. Lidor AO, Schneider E, Segal J, Yu Q, Feinberg R, Wu AW. Elective surgery for diverticulitis is associated with high risk of intestinal diversion and hospital readmission in older adults. J Gastrointest Surg. 2010;14:1867–73.

    PubMed  Google Scholar 

  88. Jensen DM, Machicado GA, Jutabha R, Kovacs TOG. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage. N Engl J Med. 2000;342:78–82.

    CAS  PubMed  Google Scholar 

  89. McGuire HH. Bleeding colonic diverticula: a reappraisal of natural history and management. Ann Surg. 1994;220:653–6.

    PubMed  PubMed Central  Google Scholar 

  90. Gilshtein H, Kluger Y, Khoury A, Issa N, Khoury W. Massive and recurrent diverticular hemorrhage, risk factors and treatment. Int J Surg. 2016;33:136–9.

    PubMed  Google Scholar 

  91. Lewis M. Bleeding colonic diverticula. J Clin Gastroenterol. 2008;42:1156–8.

    PubMed  Google Scholar 

  92. Meyers MA, Alonso DR, Gray GF, Baer JW. Pathogenesis of bleeding colonic diverticulosis. Gastroenterology. 1976;71:577–83.

    CAS  PubMed  Google Scholar 

  93. • Strate LL, Liu YL, Huang ES, et al. Use of aspirin or nonsteroidal anti-inflammatory drugs increases risk for diverticulitis and diverticular bleeding. Gastroenterology 2011; 140: 1427–1433. This is one of the seminal papers outlining the risk of NSAIDs in diverticulitis and diverticular bleeding.

    CAS  PubMed  PubMed Central  Google Scholar 

  94. Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL. Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology. 2009;136:115–22 e1.

    PubMed  Google Scholar 

  95. Yamada A, Sugimoto T, Kondo S, Ohta M, Watabe H, Maeda S, et al. Assessment of the risk factors for colonic diverticular hemorrhage. Dis Colon Rectum. 2008;51:116–20.

    PubMed  Google Scholar 

  96. Okamoto T, Watabe H, Yamada A, et al. The association between arteriosclerosis related diseases and diverticular bleeding. Int J Colorectal Dis 2012;27(9):1161–6.

    PubMed  Google Scholar 

  97. Bokhari M, Am V, Ure T, Longo WE. Diverticular hemorrhage in the elderly—is it well tolerated? Dis Colon Rectum. 1996;39(2):191–5.

    CAS  PubMed  Google Scholar 

  98. Parks TG. Natural history of diverticular disease of the colon: a review of 521 cases. Br Med J. 1969;4(5684):639–42.

    CAS  PubMed  PubMed Central  Google Scholar 

  99. Broderick-Villa G, Burchette RJ, Collins JC, Abbas MA, Haigh PI. Hospitalization for acute diverticulitis does not mandate routine elective colectomy. Arch Surg. 2005;140:576–81.

    PubMed  Google Scholar 

  100. Anaya DA, Flum DR. Risk of emergency colectomy and colostomy in patient with diverticular disease. Arch Surg. 2005;140:681–5.

    PubMed  Google Scholar 

  101. Eglinton T, Nguyen T, Raniga S, Dixon L, Dobbs B, Frizelle FA. Patterns of recurrence in patients with acute diverticulitis. Br J Surg. 2010;97:952–7.

    CAS  PubMed  Google Scholar 

  102. Salem L, Veenstra DL, Sullivan SD, Flum DR. The timing of elective colectomy in diverticulitis: a decision analysis. J Am Coll Surg. 2004;199:904–12.

    PubMed  Google Scholar 

  103. Wolff BG, Ready RL, McCarty RL, et al. Influence of sigmoid resection on progression of diverticular disease of the colon. Dis Colon Rectum. 1984;27:645–7.

    CAS  PubMed  Google Scholar 

  104. Farmakis N, Tudor RG, Keighley MR. The 5-year natural history of complicated diverticular disease. Br J Surg. 1994;81:733–5.

    CAS  PubMed  Google Scholar 

  105. Moreaux J, Vons C. Elective resection for diverticular disease of the sigmoid colon. Br J Surg. 1990;77:1036–8.

    CAS  PubMed  Google Scholar 

  106. Benn PL, Wolff BG, Ilstrup DM. Level of anastomosis and recurrent colonic diverticulitis. Am J Surg. 1986;151:269–71.

    CAS  PubMed  Google Scholar 

  107. Thorn M, Graf W, Stefansson T, Pahlman L. Clinical and functional results after elective colonic resection in 75 consecutive patients with diverticular disease. Am J Surg. 2002;183:7–11.

    PubMed  Google Scholar 

  108. Netri G, Verbo A, Coco C, et al. The role of surgical treatment in colon diverticulitis: indications and results. Ann Ital Chir. 2000;71:209–14.

    CAS  PubMed  Google Scholar 

  109. Chodak GW, Rangel DM, Passaro E Jr. Colonic diverticulitis in patients under age 40: need for earlier diagnosis. Am J Surg. 1981;141:699–702.

    CAS  PubMed  Google Scholar 

  110. Ambrosetti P, Robert J, Witzig JA, Mirescu D, de Gautard R, Borst F, et al. Prognostic factors from computed tomography in acute left colonic diverticulitis. Br J Surg. 1992;79:117–9.

    CAS  PubMed  Google Scholar 

  111. Eusebio EB, Eisenberg MM. Natural history of diverticular disease of the colon in young patients. Am J Surg. 1973;125:308–11.

    CAS  PubMed  Google Scholar 

  112. Schauer PR, Ramos R, Chiatas AA, Sirinek KR. Virulent diverticular disease in young obese men. Am J Surg. 1992;164(5):443–6.

    CAS  PubMed  Google Scholar 

  113. Morris CR, Harvey IM, Stebbings WSL, Speakman CT, Kennedy HJ, Hart AR. Do calcium channel blockers and antimuscurinics protect against perforated colonic diverticular disease? A case control study. Gut. 2003;52(12):1734–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  114. Brandt LJ, Feuerstadt P, Longstreth GF, Boley SJ. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis and management of colonic ischemia. Am J Gastroenterol. 2015;110:18–44.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA

    Mona Rezapour

  2. Alta Bates Summit Medical Center, East Bay Center for Digestive Health, 300 Frank H Ogawa Plaza, Suite 450, Oakland, CA, 94612, USA

    Neil Stollman

Authors
  1. Mona Rezapour
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Neil Stollman
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Neil Stollman.

Ethics declarations

Conflict of Interest

Neil Stollman has consulted for AlfaSigma and Aries Pharmaceuticals.

Mona Rezapour declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Gastroenterology in Geriatric Patients

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rezapour, M., Stollman, N. Diverticular Disease in the Elderly. Curr Gastroenterol Rep 21, 46 (2019). https://doi.org/10.1007/s11894-019-0715-4

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11894-019-0715-4

Keywords