Review
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 28, 2009; 15(20): 2479-2488
Published online May 28, 2009. doi: 10.3748/wjg.15.2479
Diet, ageing and genetic factors in the pathogenesis of diverticular disease
Daniel Martin Commane, Ramesh Pulendran Arasaradnam, Sarah Mills, John Cummings Mathers, Mike Bradburn
Daniel Martin Commane, John Cummings Mathers, Human Nutrition Research Centre, School of Clinical Medical Sciences, University of Newcastle, NE1 8RU, United Kingdom
Ramesh Pulendran Arasaradnam, Clinical Sciences Research Institute, Medical School, University of Warwick, Coventry, CV2 2DX, United Kingdom and Human Nutrition Research Centre, School of Clinical Medical Sciences, University of Newcastle, NE1 8RU, United Kingdom
Sarah Mills, Mike Bradburn, Department of Surgery, Wansbeck General Hospital, Northumbria, NE63 9JJ, United Kingdom
Author contributions: All authors contributed equally to this manuscript.
Correspondence to: Ramesh Pulendran Arasaradnam, MB BCh BAO, C Clin Ed, PhD, MRCP, Clinical Sciences Research Institute, Medical School, University of Warwick, Coventry, CV2 2DX, United Kingdom. r.arasaradnam@warwick.ac.uk
Telephone: +44-2476-966087
Fax: +44-2476-966096
Received: January 9, 2009
Revised: April 22, 2009
Accepted: April 29, 2009
Published online: May 28, 2009
Abstract

Diverticular disease (DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK. This high prevalence ranks it as one of the most common bowel disorders in western nations. The majority of patients remain asymptomatic but there are associated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum. Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality. In the 1970s, a model of DD formulated the concept that diverticula occur as a consequence of pressure-induced damage to the colon wall amongst those with a low intake of dietary fiber. In this review, we have examined the evidence regarding the influence of ageing, diet, inflammation and genetics on DD development. We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal. We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease.

Keywords: Diverticular disease; Dietary factors; Genetics; Colon; Inflammation