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Clin Colon Rectal Surg 2011; 24(4): 253-258
DOI: 10.1055/s-0031-1295688
Published by Thieme Medical Publishers

Diverticular Disease and the Obese Patient

Eric K. Johnson1 , 2 , Bradley J. Champagne3
  • 1Uniformed Services University of the Health Sciences, Department of Surgery, Dwight David Eisenhower Army Medical Center, Ft. Gordon, Georgia
  • 2current affiliation: Department of Surgery/General Surgery, Madigan Army Medical Center, Ft. Lewis, Washington
  • 3Department of Surgery, University Hospitals Case Medical Center, Cleveland, Ohio
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Publication History

Publication Date:
06 December 2011 (online)

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ABSTRACT

Diverticular disease is common in the Western world and is a considerable source of morbidity. Many have proposed an association between diverticular disease, its complications, and obesity. We examine this question through a review of the available literature. While it is likely that an association between diverticular disease and obesity exists, there is no evidence suggesting that obese patients should be managed any differently from the non-obese.

KEYWORDS

Diverticulitis - obesity - complicated diverticular disease

REFERENCES

  • 1 Kang J Y, Melville D, Maxwell J D. Epidemiology and management of diverticular disease of the colon.  Drugs Aging. 2004;  21 (4) 211-228
    Google Scholar
  • 2 Morris C R, Harvey I M, Stebbings W SL, Speakman C TM, Kennedy H J, Hart A R. Epidemiology of perforated colonic diverticular disease.  Postgrad Med J. 2002;  78 (925) 654-658
    Google Scholar
  • 3 Flegal K M, Carroll M D, Kuczmarski R J, Johnson C L. Overweight and obesity in the United States: prevalence and trends, 1960-1994.  Int J Obes Relat Metab Disord. 1998;  22 (1) 39-47
    Google Scholar
  • 4 Schauer P R, Ramos R, Ghiatas A A, Sirinek K R. Virulent diverticular disease in young obese men.  Am J Surg. 1992;  164 (5) 443-446 discussion 446-448
    Google Scholar
  • 5 Konvolinka C W. Acute diverticulitis under age forty.  Am J Surg. 1994;  167 (6) 562-565
    Google Scholar
  • 6 Langdon D E. Obesity associated with severe acute colonic diverticulitis in the young adult.  Am J Gastroenterol. 2000;  95 (5) 1373
    Google Scholar
  • 7 Dobbins C, Defontgalland D, Duthie G, Wattchow D A. The relationship of obesity to the complications of diverticular disease.  Colorectal Dis. 2006;  8 (1) 37-40
    Google Scholar
  • 8 Zaidi E, Daly B. CT and clinical features of acute diverticulitis in an urban U.S. population: rising frequency in young, obese adults.  AJR Am J Roentgenol. 2006;  187 (3) 689-694
    Google Scholar
  • 9 Korzenik J R. NDSG . Diverticulitis: new frontiers for an old country: risk factors and pathogenesis.  J Clin Gastroenterol. 2008;  42 (10) 1128-1129
    Google Scholar
  • 10 Strate L L, Liu Y L, Aldoori W H, Syngal S, Giovannucci E L. Obesity increases the risks of diverticulitis and diverticular bleeding.  Gastroenterology. 2009;  136 (1) 115-122 e1
    Google Scholar
  • 11 Burkitt D P, Walker A R, Painter N S. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease.  Lancet. 1972;  2 (7792) 1408-1412
    Google Scholar
  • 12 Aldoori W H, Giovannucci E L, Rimm E B, Wing A L, Trichopoulos D V, Willett W C. A prospective study of diet and the risk of symptomatic diverticular disease in men.  Am J Clin Nutr. 1994;  60 (5) 757-764
    Google Scholar
  • 13 Sorser S A, Hazan T B, Piper M, Maas L C. Obesity and complicated diverticular disease: is there an association?.  South Med J. 2009;  102 (4) 350-353
    Google Scholar
  • 14 Kim J H, Cheon J H, Park S et al.. Relationship between disease location and age, obesity, and complications in Korean patients with acute diverticulitis: a comparison of clinical patterns with those of Western populations.  Hepatogastroenterology. 2008;  55 (84) 983-986
    Google Scholar
  • 15 Buckley O, Ward E, Ryan A, Colin W, Snow A, Torreggiani W C. European obesity and the radiology department. What can we do to help?.  Eur Radiol. 2009;  19 (2) 298-309
    Google Scholar
  • 16 Polotsky H N, Polotsky A J. One size may not fit all: pondering antibiotic dosing in obesity.  Maturitas. 2010;  66 (4) 381-382
    Google Scholar
  • 17 Falagas M E, Karageorgopoulos D E. Adjustment of dosing of antimicrobial agents for bodyweight in adults.  Lancet. 2010;  375 (9710) 248-251
    Google Scholar
  • 18 Wurtz R, Itokazu G, Rodvold K. Antimicrobial dosing in obese patients.  Clin Infect Dis. 1997;  25 (1) 112-118
    Google Scholar
  • 19 Hollenstein U M, Brunner M, Schmid R, Müller M. Soft tissue concentrations of ciprofloxacin in obese and lean subjects following weight-adjusted dosing.  Int J Obes Relat Metab Disord. 2001;  25 (3) 354-358
    Google Scholar
  • 20 Smyth E T, Emmerson A M. Surgical site infection surveillance.  J Hosp Infect. 2000;  45 (3) 173-184
    Google Scholar
  • 21 Smith R L, Bohl J K, McElearney S T et al.. Wound infection after elective colorectal resection.  Ann Surg. 2004;  239 (5) 599-605 discussion 605-607
    Google Scholar
  • 22 Duchesne J C, Wang Y Z, Weintraub S L, Boyle M, Hunt J P. Stoma complications: a multivariate analysis.  Am Surg. 2002;  68 (11) 961-966 discussion 966
    Google Scholar
  • 23 Liu W H, Pai L, Wu C C, Jao S W, Yeh C C, Hsiao C W. Postoperatively parastomal infection following emergent stoma creation for colorectal obstruction: the possible risk factors.  Int J Colorectal Dis. 2008;  23 (9) 869-873
    Google Scholar
  • 24 Bouillot J L, Berthou J C, Champault G et al.. Elective laparoscopic colonic resection for diverticular disease: results of a multicenter study in 179 patients.  Surg Endosc. 2002;  16 (9) 1320-1323
    Google Scholar
  • 25 Belizon A, Sardinha C T, Sher M E. Converted laparoscopic colectomy: what are the consequences?.  Surg Endosc. 2006;  20 (6) 947-951
    Google Scholar
  • 26 Tuech J J, Regenet N, Hennekinne S, Pessaux P, Bergamaschi R, Arnaud J P. Laparoscopic colectomy for sigmoid diverticulitis in obese and nonobese patients: a prospective comparative study.  Surg Endosc. 2001;  15 (12) 1427-1430
    Google Scholar
  • 27 Pessaux P, Muscari F, Ouellet J F et al.. Risk factors for mortality and morbidity after elective sigmoid resection for diverticulitis: prospective multicenter multivariate analysis of 582 patients.  World J Surg. 2004;  28 (1) 92-96
    Google Scholar
  • 28 Redan J A, McCarus S D. Protect the ureters.  JSLS. 2009;  13 (2) 139-141
    Google Scholar
  • 29 Senagore A J, Luchtefeld M. An initial experience with lighted ureteral catheters during laparoscopic colectomy.  J Laparoendosc Surg. 1994;  4 (6) 399-403
    Google Scholar
  • 30 Blake M F, Dwivedi A, Tootla A, Tootla F, Silva Y J. Laparoscopic sigmoid colectomy for chronic diverticular disease.  JSLS. 2005;  9 (4) 382-385
    Google Scholar

Eric K. JohnsonM.D. 

Department of Surgery/General Surgery, Madigan Army Medical Center

9040A Fitzsimmons Dr., Ft. Lewis, WA 98431

Email: doktrj@gmail.com