Divertikkelsykdom: Årsaker
Det er sannsynligvis et samspill mellom flere faktorer som legger grunnlaget for divertikkelsykdom. Mekanismen er økt trykk i tarmen kombinert med svake partier i tarmveggen som gir etter for det høye trykket. Flere forhold kan gjøre deg mer utsatt for å utvikle denne sykdommen:
Annonse
- Forstoppelse ser ut til å øke risikoen for å få divertikler
- Det er noe økt hyppighet hos personer som har fått diagnosen irritabel tarm
- Fiberfattig kosthold har i mange år vært oppfattet som en sterk risikofaktor, og personer som spiser 20-40g kostfiber om dagen har lavere forekomst av divertikkelsykdom enn de som spiser 7,5g om dagen. Forekomsten av divertikulose er lavere blant vegetarianere og i sivilisasjoner som har et mer fiberrikt kosthold
- Økende forekomst med økende alder
Vil du vite mer
Illustrasjoner
Dette dokumentet er basert på det profesjonelle dokumentet Divertikkelsykdom . Referanselisten for dette dokumentet vises nedenfor
Referanser
- Andersen JC, Bundgaard L, Elbrønd H, et al. Danish national guidelines for treatment of diverticular disease. Dan Med J. 2012 May;59(5):C4453. PubMed
- Rezapour M, Ali S, Stollman N. Diverticular Disease: An Update on Pathogenesis and Management. Gut Liver. 2018 Mar 15;12(2):125-132. PMID: 28494576. PubMed
- Thaha MA, Carrington E. Diverticular disease. BMJ BestPractice, last updated 15 Oct 2019. bestpractice.bmj.com
- Young-Fadok TM. Diverticulitis. N Engl J Med. 2018 Oct 25;379(17):1635-1642. PMID: 30354951. PubMed
- Matrana MR, Margolin DA. Epidemiology and pathophysiology of diverticular disease. Clin Colon Rectal Surg. 2009 Aug;22(3):141-6. PubMed
- Delveus H, Lanzing G, Sahli H, Rönnow CF, Dahlbäck C, Buchwald P. Diverticulosis and risk of diverticulitis in 10 years; a Swedish retrospective observational study. Scand J Gastroenterol. 2024;59(4):433-436.PMID: 38206087 PubMed
- Helsedirektoratet. Nasjonal faglig retningslinje for antibiotika i primærhelsetjenesten nettdokument. Sist faglig oppdatert 16. november 2021. www.helsedirektoratet.no
- Bharucha AE, Parthasarathy G, Ditah I, et al. Temporal trends in the incidence and natural history of diverticulitis: a population-based study. Am J Gastroenterol, 29 September 2015 . doi:10.1038/ajg.2015.302 DOI
- Gralnek IM, Neeman Z, Strate LL. Acute lower gastrointestinal bleeding. N Engl J Med. 2017;376(11):1054–1063. PMID: 28296600 PubMed
- Pemberton JH. Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and pathogenesis. UpToDate, last updated Dec 16, 2019. UpToDate
- Aune D, Sen A, Norat T, Riboli E. Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies. Eur J Nutr. 2020;59(2):421-432. PMID: 31037341 PubMed
- Crowe FL, Appleby PN, Allen NE, Key TJ. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians . BMJ 2011; 343: d4131. BMJ (DOI)
- Jung HK, Choung RS, Locke GR, et al. Diarrhea-predominant irritable bowel syndrome is associated with diverticular disease: a population-based study.. Am J Gastroenterol 2010; 105: 652-61. PubMed
- Bailey J, Dattani S, Jennings A. Diverticular Disease: Rapid Evidence Review. Am Fam Physician. 2022;106(2):150-156. PubMed
- Shah SD, Cifu AS. Management of acute diverticulitis. JAMA 2017; 318: 291-2. doi:10.1001/jama.2017.6373 DOI
- Kupcinskas J, Strate LL, Bassotti G, et al. Pathogenesis of Diverticulosis and Diverticular Disease. J Gastrointestin Liver Dis. 2019;28(suppl. 4):7-10. Published 2019 Dec 19. PMID: 31930230 PubMed
- Strate LL, Liu YL, Huang ES, et al. Use of aspirin or nonsteroidal anti-inflammatory drugs increases risk for diverticulitis and diverticular bleeding. Gastroenterology 2011; 140: 1427-33. Gastroenterology
- van Dijk ST, Daniels L, de Korte N, et al. Quality of Life and Persistent Symptoms After Uncomplicated Acute Diverticulitis. Dis Colon Rectum. 2019 May;62(5):608-614. pmid:30807455 PubMed
- Thorson CM, Paz Ruiz PS, Roeder RA, et al. The perforated duodenal diverticulum. Arch Surg. 2012;147):81-8. PMID: 22250120 PubMed
- Aune D, Sen A, Norat T, Riboli E. Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies. Eur J Nutr. 2020;59(2):421-432. PubMed
- Helsedirektoratet. Divertikulitt. Antibiotika i sykehus, sist oppdatert 08.01.2018. helsedirektoratet.no
- Dichman ML, Rosenstock SJ, Shabanzadeh DM. Antibiotics for uncomplicated diverticulitis. Cochrane Database Syst Rev. 2022 Jun 22;6(6):CD009092. doi: 10.1002/14651858.CD009092.pub3 DOI
- Schultz JK, Yaqub S, Øresland T. Management of diverticular disease in Scandinavia. J Clin Gastroentrol 2016; 50: Supp.1 50-52. PMID: 27622365 PubMed
- Daniels L, Ünlü Ç, de Korte N, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. BJS 2016. doi:10.1002/bjs.10309 DOI
- Jaung R, Nisbet S, Gosselink MP, et al. Antibiotics Do Not Reduce Length of Hospital Stay for Uncomplicated Diverticulitis in a Pragmatic Double-Blind Randomized Trial. Clin Gastroenterol Hepatol, 2020. pmid:32240832 PubMed
- van Dijk ST, Daniels L, Unlu C, et al. Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis. Am J Gastroenterol 2018. pmid:29700480 PubMed
- Lidor AO, Segal JB, Wu AW, et al. Older patients with diverticulitis have low recurrence rates and rarely need surgery. Surgery 2011; 150: 146-53. Surgery
- Schultz JK, Yaqub S, Wallon C, et al. Laparoscopic lavage vs primary resection for acute perforated diverticulitis. The SCANDIV randomized clinical trial. JAMA 2015; 314: 1364-75. doi:10.1001/jama.2015.12076 DOI
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten und Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie . Divertikelkrankheit/Divertikulitis. AWMF-Leitlinie Nr. 021-020, Stand 2021. www.awmf.org
- Chen CY, Wu CC, Jao SW, Pai L, Hsiao CW. Colonic diverticular bleeding with comorbid diseases may need elective colectomy. J Gastrointest Surg 2009; 13: 516-20 PubMed
- Hawkins AT, Wise PE, Chan T, et al. Diverticulitis: An Update From the Age Old Paradigm. Curr Probl Surg. 2020;57(10):100862. PubMed
- Salem TA, Molloy RG, O'Dwyer PJ. Prospective, five-year follow-up study of patients with symptomatic uncomplicated diverticular disease. Dis Colon Rectum 2007; 50: 1460-4. PubMed