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Diverticulitis increased risk for IBS
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Patients with acute diverticulitis were more likely to develop irritable bowel syndrome, according to a recent retrospective study.
During a mean follow-up of 6.3 years, researchers evaluated 1,102 patients with diverticulitis and 1,102 matched controls. Incidence of IBS after diverticulitis among cases, or enrollment date among controls, was observed and compared between groups. New diagnoses of functional bowel disorders such as constipation, abdominal pain, functional diarrhea or spastic colon were noted, as were diagnoses of mood disorders.
“This study expands our understanding about what might cause IBS,” researcher Brennan M.R. Spiegel, MD, associate professor of medicine at David Geffen School of Medicine at UCLA, said in a press release. “The prevailing wisdom has been that once diverticulitis is treated, it’s gone. But we’ve shown that IBS symptoms occur after the diverticulitis, and it may result from an inflammatory response like a bomb going off in the body and leaving residual damage.”
IBS developed in 20 cases and four controls during follow-up. Survival analysis indicated that patients with diverticulitis were significantly more likely than controls to later be diagnosed with IBS, after adjustment for age, sex, race/ethnicity, comorbidities and inpatient/outpatient status (adjusted HR=4.7; 95% CI, 1.6-14).
New diagnoses of functional bowel disorders occurred in 95 cases and 51 controls, and mood disorders were diagnosed in 63 cases and 35 controls. Patients with diverticulitis were at increased risk for both (aHR=2.4; 95% CI, 1.6-3.6 and aHR=2.2; 95% CI, 1.4-3.5, respectively).
The researchers proposed that post-diverticulitis IBS (PDV-IBS) is a distinct disease form and called for research to determine potential predictors and to further evaluate the link between diverticulitis and IBS.
“Our findings support the evolving paradigm of diverticular disease as a chronic illness, not merely an acute condition marked by abrupt complications,” the investigators concluded. “Far from a self-limited episode, acute diverticulitis may become a chronic disorder in some patients. … Enhanced awareness of the potential long-term impact of diverticulitis, including the possibility of PDV-IBS, may allow for more timely diagnosis and treatment.”
Disclosure: See the study for a full list of relevant financial disclosures.
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