Do diverticula provide a unique niche for microbiota which can lead to activation of the innate immune system?

As individuals living a Western lifestyle age, the prevalence of diverticulosis steadily rises reaching around 50% over the age of 75 years.1 While for most this is a harmless ageing change reflecting weakening of colonic connective tissue, around 30% suffer recurrent abdominal pain, often with diarrhoea,2 and 1–4% will be hospitalised with diverticulitis.3 As our population steadily ages this represents a substantial health burden, however, we know surprisingly little about the underlying mechanisms of this disease. Heritability of symptomatic diverticular disease is around 40%,4 however, studies of immigrants from low-risk areas to high-risk countries show that environmental factors are equally important.3 Once hospitalised with diverticulitis the risk of further hospitalisation is around 1% per year but the majority continue to suffer pain or bowel disturbance, at least for the 1st year after discharge.5 Diverticulitis is associated with inflammation,...
Source: Gut - Category: Gastroenterology Authors: Tags: Commentary Source Type: research

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To evaluate whether oxycodone use for postoperative pain control after hysterectomy for benign disease differs based on hysterectomy route.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Non-Oral Poster Source Type: research
The aim of this study is to assess whether the use of MRI as part of preoperative workup in the setting of patients with chronic pelvic pain and presumed diagnosis of endometriosis is predictive of pathology-proven endometriosis.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Non-Oral Poster Source Type: research
Despite the increasing morbidity and mortality of the opioid epidemic, the rates of pain medication use among the urogynecology patient population is not known. Our objective was to describe the baseline prevalence of preoperative opioid and neuropathic pain medication use in patients presenting for urogynecologic surgery and to determine whether this rate changed before and after passage of anti-opioid state legislation.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Non-Oral Poster Source Type: research
ConclusionThe diagnosis of severe acute UC in elderly patients with acute abdomen had been complicated by the distinctive physiology of this aged group with atypical presentation and markedly unreliable physical examination. Eventually, severe UC should always be kept in mind with a circumstance of abdominal pain in geriatric population.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
We reported a case of a 70-year-old female who presented to our Emergency Department (ED) with right upper quadrant pain and an initial clinical suspicion of cholecystitis. Ultrasound (US) and Computed Tomography (CT) demonstrated an anatomical variation of the sigmoid colon diverticulitis. This clinical report demonstrates that ultrasound plays a relevant part as first-step approach to the acute abdominal conditions and its accuracy increases together with other diagnostic tools such as Computer Tomography.
Source: Critical Ultrasound Journal - Category: Radiology Source Type: research
Case Report: A 58-year-old female presented with a 4-day history of lower abdominal pain, loss of appetite and diarrhoea. Her past medical history included a partial salpingectomy, total abdominal hysterectomy and bilateral salpingo-oophorectomy and abdominal sacrocolpoplexy. On examination, she was tender across the lower abdomen, with voluntary guarding. Her blood results showed elevated inflammatory markers. Being treated conservatively for presumed acute diverticulitis, she progressed to develop vomiting, and abdominal computed tomography (CT) showed findings consistent with small bowel obstruction with a transition po...
Source: International Journal of Surgery - Category: Surgery Authors: Source Type: research
CONCLUSIONS: The effects of 5-ASA on recurrence of diverticulitis are uncertain owing to the small number of heterogenous trials included in this review. Rates of recurrent diverticulitis were similar among participants using 5-ASA and control participants. Effective medical strategies for prevention of recurrent diverticulitis are needed, and further randomised, double-blinded, placebo-controlled trials of rigorous design are warranted to specify the effects of 5-ASA (mesalamine) in the management of diverticulitis. PMID: 28973845 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
This study is registered with ClinicalTrials.gov, number NCT01301066. Findings Between Feb 23, 2011, and March 29, 2013, we randomly assigned 252 patients to the pitavastatin (n=126) or pravastatin group (n=126). LDL cholesterol reduction was 31·1% with pitavastatin and 20·9% with pravastatin (least squares mean difference −9·8%, 95% CI −13·8 to −5·9; p<0·0001) at 12 weeks. At week 52, four patients (3%) in the pitavastatin group and six (5%) in the pravastatin group had virological failure, with no significant difference between treatments. Both treatments had...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research
CONCLUSION: About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients. PMID: 28028368 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Conclusion A pneumoportogram (hepatic portal venous gas, HPVG) is a very rare and usually associated with bowel ischemia and from poor prognosis. The last decades saw the emergence of numerous other aetiologies (also benign) with a shift of paradigm from systematic emergency laparotomies to individual patient selection.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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