Department of Medicine Solna, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Gastroenterology, Baylor College of Medicine, Houston, Texas.
Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.
Clin Gastroenterol Hepatol. 2016 Dec;14(12):1763-1770.e1. doi: 10.1016/j.cgh.2016.06.014. Epub 2016 Jun 21.
BACKGROUND & AIMS: Symptomatic uncomplicated diverticular disease is considered to be a discreet clinical entity distinct from irritable bowel syndrome (IBS), but population-based data are unavailable. We aimed to investigate the prevalence and location of diverticulosis in the general population, and its association with colonic symptoms and mental health. We propose that individuals with diverticulosis would report more constipation and IBS.
We performed a population-based study of randomly selected adults born in Sweden (age, 18-70 y; 57.2% women); 745 received a gastroenterology consultation, completed validated abdominal symptom and mental health questionnaires, and were examined by colonoscopy. Logistic regression was used to calculate the associations between diverticulosis and age, sex, gastrointestinal symptoms, anxiety, depression, and self-rated health.
Among the 742 participants (54.6% women), 130 (17.5%) had diverticulosis. Age was the strongest predictor of diverticulosis (P < .001), and diverticulosis was rare in participants younger than 40 years (0.7%). All participants with diverticulosis had sigmoid involvement. Participants with diverticulosis were more likely to report loose stools (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.20-2.96), urgency (OR, 1.64; 95% CI, 1.02-2.63), passing mucus (OR, 2.26; 95% CI, 1.08-4.72), and a high stool frequency (OR, 2.02; 95% CI, 1.11-3.65). Diverticulosis was associated with abdominal pain (OR, 2.10; 95% CI, 1.01-4.36; P = .047) and diarrhea-predominant IBS (OR, 9.55; 95% CI, 1.08-84.08; P = .04) in participants older than 60 years. The presence of anxiety and depression and self-rated health were similar in participants with and without diverticulosis.
The prevalence of diverticulosis is age-dependent. Diverticulosis is associated with diarrhea in subjects across all age ranges. In subjects older than age 60, diverticulosis is associated with abdominal pain and diarrhea-predominant IBS.
有症状的单纯性憩室病被认为是一种与肠易激综合征（IBS）不同的独立临床实体，但目前尚无基于人群的数据。我们旨在研究普通人群中憩室病的患病率和位置，以及其与结肠症状和心理健康的关系。我们假设憩室病患者会报告更多的便秘和 IBS。
我们对瑞典出生的随机选择的成年人进行了一项基于人群的研究（年龄 18-70 岁；57.2%为女性）；745 人接受了胃肠病学咨询，完成了经过验证的腹部症状和心理健康问卷，并接受了结肠镜检查。使用逻辑回归计算憩室病与年龄、性别、胃肠道症状、焦虑、抑郁和自我评估健康之间的关联。
在 742 名参与者（54.6%为女性）中，有 130 名（17.5%）患有憩室病。年龄是憩室病最强的预测因素（P<0.001），40 岁以下的参与者中憩室病很少见（0.7%）。所有憩室病患者均有乙状结肠受累。患有憩室病的参与者更有可能报告大便松软（比值比 [OR]，1.88；95%置信区间 [CI]，1.20-2.96）、急迫感（OR，1.64；95%CI，1.02-2.63）、排黏液（OR，2.26；95%CI，1.08-4.72）和高粪便频率（OR，2.02；95%CI，1.11-3.65）。憩室病与 60 岁以上患者的腹痛（OR，2.10；95%CI，1.01-4.36；P=0.047）和腹泻为主型 IBS（OR，9.55；95%CI，1.08-84.08；P=0.04）相关。患有和不患有憩室病的参与者的焦虑和抑郁以及自我评估健康状况相似。
憩室病的患病率与年龄有关。憩室病与所有年龄段的腹泻有关。在 60 岁以上的患者中，憩室病与腹痛和腹泻为主型 IBS 相关。
