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Harrison's Principles of Internal Medicine, 18e
| Part 14. Disorders of the Gastrointestinal System > Section 1. Disorders of the Alimentary Tract > |
Chapter 297. Diverticular Disease and Common Anorectal Disorders
Sections: Diverticular Disease, Common Diseases of the Anorectum, Acknowledgment, Further Readings.
Topics Discussed: anorectal disorder; diverticular disease of colon.
Excerpt:"Among Western populations, diverticulosis of the colon affects nearly one-half of individuals older than age 60 years. Fortunately, only 20% of patients with diverticulosis develop symptomatic disease. However, in the United States, diverticular disease results in >200,000 hospitalizations annually, making it the fifth most costly gastrointestinal disorder. The incidence of the disease is on the rise, mainly among young patients. The mean age at presentation of the disease is 59 years. Although the prevalence among females and males is similar, males tend to present at a younger age. Diverticulosis is rare in underdeveloped countries, where diets include more fiber and roughage. However, shortly following migration to the United States, immigrants will develop diverticular disease at the same rate as U.S. natives.Asymptomatic diverticular disease discovered on imaging studies or at the time of colonoscopy is best managed by diet alterations. Patients should be instructed to eat a fiber-enriched diet that includes 30 g of fiber each day. Supplementary fiber products such as Metamucil, Fibercon, or Citrucel are useful. The incidence of complicated diverticular disease appears to be increased in patients who smoke. Therefore, patients should be encouraged to refrain..."
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