ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2018
Colonic Diverticula Are Not Associated With Mucosal Inflammation or Chronic Gastrointestinal Symptoms.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 83 citations in OpenAlex.
- Do Colonic Mucosal Tumor Necrosis Factor Alpha Levels Play a Role in Diverticular Disease? A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2023Pooled it
- Association betweenBMJ open gastroenterology · 2026Observational
- Utility of Colonoscopy After Acute Colonic Diverticulitis.Diagnostics (Basel, Switzerland) · 2026Review
- Proton pump inhibitor use is not independently associated with colonic diverticulosis in an asymptomatic screening population.Scientific reports · 2026Observational
- The Epidemiology of Diverticulitis.Clinics in colon and rectal surgery · 2025Review
- Management of Colonic Diverticular Disease in the Older Adult.Current gastroenterology reports · 2025Review
- Association between Cardiovascular Risk Assessment by SCORE2 and Diverticulosis: A Cross-Sectional Analysis.Journal of personalized medicine · 2024Article
- Site and duration of abdominal pain discriminate symptomatic uncomplicated diverticular disease from previous diverticulitis patients.Internal and emergency medicine · 2024Observational
- The Impact of Educational Status on the Occurrence of Colonic Diverticula: Insights from an Austrian Cohort Study.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2024Article
- Genetic Variants in Matrix MetalloproteinasesMedicina (Kaunas, Lithuania) · 2023Article
- Increased mucosal eosinophils in colonic diverticulosis and diverticular disease.Journal of gastroenterology and hepatology · 2023Article
- Diverticular Disease Worsening Is Associated with Increased Oxidative Stress and Gut Permeability: New Insights by Circulating Biomarkers.Antioxidants (Basel, Switzerland) · 2023Article
- Symptomatic Uncomplicated Diverticular Disease (SUDD): Practical Guidance and Challenges for Clinical Management.Clinical and experimental gastroenterology · 2023Review
- New German guidelines for the management of diverticulitis.United European gastroenterology journal · 2022Article
- Pathophysiology of Diverticular Disease: From Diverticula Formation to Symptom Generation.International journal of molecular sciences · 2022Review
- Colonic Diverticulosis Is Not Associated With Painful Abdominal Symptoms in a US Population.Gastro hep advances · 2022Article
- Microbiota composition and mucosal immunity in patients with asymptomatic diverticulosis and controls.PloS one · 2021Article
- The natural history of symptomatic uncomplicated diverticular disease: a long-term follow-up study.Annals of gastroenterology · 2021Article
- Association between Betel Nut and Presence of Diverticulum in Male: A Cross-Sectional Study.BioMed research international · 2021Article
- Role of Inflammation in Pathophysiology of Colonic Disease: An Update.International journal of molecular sciences · 2020Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsColonic diverticulosis has been reported to be associated with low-grade mucosal inflammation, possibly leading to chronic gastrointestinal symptoms. However, there is poor evidence for this association. We aimed to determine mucosal inflammation and whether diverticula are associated with chronic gastrointestinal symptoms. We explored whether inflammation was present among symptomatic participants with and without diverticula.
methodsWe analyzed data from a prospective study of 619 patients undergoing a screening colonoscopy from 2013 through 2015 at the University of North Carolina Hospital in Chapel Hill, North Carolina. Among our participants, 255 (41%) had colonic diverticula. Colonic mucosal biopsy specimens were analyzed for levels of interleukin 6 (IL6), IL10, and tumor necrosis factor messenger RNAs by quantitative reverse-transcriptase polymerase chain reaction, and numbers of immune cells (CD4+, CD8+, CD57+, and mast cell tryptase) by immunohistochemistry. Gastrointestinal symptoms were assessed using Rome III criteria. Proportional odds models were used to estimate odds ratios (ORs) and 95% confidence interval (CIs).
resultsAfter adjustment for potential confounders, there was no association between diverticulosis and tumor necrosis factor (OR, 0.85; 95% CI, 0.63-1.16), and no association with CD4+ cells (OR, 1.18; 95% CI, 0.87-1.60), CD8+ cells (OR, 0.97; 95% CI, 0.71-1.32), or CD57+ cells (OR, 0.80; 95% CI, 0.59-1.09). Compared with controls without diverticulosis, biopsy specimens from individuals with diverticulosis were less likely to express the inflammatory cytokine IL6 (OR, 0.59; 95% CI, 0.36-0.96). There was no association between diverticulosis and irritable bowel syndrome (OR, 0.53; 95% CI, 0.26-1.05) or chronic abdominal pain (OR, 0.68; 95% CI, 0.38-1.23). There was no evidence for inflammation in patients with symptoms when patients with vs without diverticulosis were compared.
conclusionsWe found no evidence that colonic diverticulosis is associated with mucosal inflammation or gastrointestinal symptoms. Among patients with symptoms and diverticula, we found no mucosal inflammation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.