Published online Jul 21, 2021. doi: 10.3748/wjg.v27.i27.4441
Peer-review started: April 27, 2021
First decision: May 27, 2021
Revised: June 6, 2021
Accepted: July 9, 2021
Article in press: July 9, 2021
Published online: July 21, 2021
Colonic diverticulosis is a common abnormality of the colon. The prevalence of diverticulosis and diverticular disease in Japan is increasing due to aging and a westernized diet.
Recent trends in the prevalence and distribution of colonic diverticula in Japan are not clear. Most recent studies on diverticulosis in Japan involved the use of colonoscopy. In recent years, computed tomography colonography (CTC) has been widely used as an alternative colon cancer screening method. We considered CTC to detect diverticula as outpouchings of the colonic wall from a more advantageous perspective, and it may be superior to colonoscopy and barium enema for detecting diverticula.
The main objective of this study was to evaluate the prevalence and distribution of colonic diverticula in Japan.
This study included 1181 participants from 14 hospitals in Japan. We analyzed the prevalence and distribution of colonic diverticula and their relationships with age and sex using CTC and analyzed the relationship between the diverticula and the length of the large intestine.
Diverticulosis was present in 48.1% of the participants. The prevalence of diverticulosis was higher in the older participants. The diverticula seen in younger participants were predominantly located in the right-sided colon and on the bilateral side for older participants. The length of the large intestine with multiple diverticula in the sigmoid colon was significantly shorter in those without diverticula.
The prevalence of colonic diverticulosis in Japan is 48.1%. This was much higher than that previously reported. In older participants, the prevalence was higher, and the distribution tended to be bilateral.
The data used in this study were slightly limited and a bit out of date. We hope to perform a large-scale prospective study after standardization of bowel preparation and imaging protocols, and CTC use will become widespread in the future. We also hope to determine the relationship between the trends in diverticulosis and its accompanying symptoms.