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Background: Colonic diverticular disease exhibits mucosal outpouchings through the large intestine. Common complications of this disease are diverticular bleeding and diverticulitis. The prevalence of the disease is age-dependent, and some patients with diverticulitis develop complications especially the elderly, the obese and those with co-morbid diseases. In a retrospective study in Chiang Mai, Thailand, the mortality rate was 3.6% at 30 days and 9.2% at 1 year., Objective: To determine the financial burden, clinical characteristics and factors associated with severity and mortality of patients with colonic diverticulitis., Material and Method: This was a retrospective study of in-patients from hospitals nationwide, and data were retrieved from three major health care system databases in the fiscal year 2010, searching for ICD code 10. Patients diagnosed with diverticular disease of the large intestine were included in this study, and baseline characteristics and clinical outcomes were analyzed. The study was approved by the institutional ethics committee of Rajavithi Hospital., Results: One thousand seven hundred and fifty patients with colonic diverticulitis were enrolled in the study and their data were analyzed. The mean age of the patients was 61.15+16.12 years old, about 70% of patients had co-morbid diseases, and the incidence of complicated colonic diverticulitis was 14.51%. The median length of hospital stay (LOS) was 6 days, half of the patients underwent surgery, and the mortality rate was 3.26%. Multivariate regression analysis revealed that the parameters associated with disease severity were number of co-morbid diseases, the universal coverage health care system, and surgical treatment, while the parameters associated with mortality were having more than two co-morbid diseases and being in the universal coverage health care system., Conclusion: Colonic diverticulitis was common in elderly patients and associated with co-morbid diseases. Most patients had mild severity but a high rate of surgery, and the mortality rate was higher than in western countries. Parameters associated with disease severity and mortality were having co-morbid disease, being in the universal coverage healthcare system and having surgical treatment.

Background: Colonic diverticular disease exhibits mucosal outpouchings through the large intestine. Common complications of this disease are diverticular bleeding and diverticulitis. Some patients with colonic diverticular disease have abdominal symptoms resembling irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder with abdominal discomfort, bloating or pain associated with disturbed defecation and unclear etiology. Some studies have shown a high prevalence of colonic diverticular disease in patients with IBS., Objective: To determine the association, clinical characteristics and factors associated with colonic diverticular disease in IBS patients compared with a control group., Material and Method: A cross-sectional prospective study was conducted at the Gastroenterology Unit, Department of Medicine, Rajavithi Hospital, Bangkok during December 2007 to January 2009. The study collected data regarding clinical characteristics, demographics and colonoscopic findings of colonic diverticular disease comparing among IBS patients, defined by Rome III criteria and control group patients. The study was approved by the institutional ethics committee of Rajavithi Hospital. Demographic data of patients were collected. The presence of diverticula, their location and number from colonoscopic findings were recorded., Results: One hundred and fifty patients were enrolled and analyzed. The patients comprised 75 patients in the IBS group and 75 patients in the control group. The prevalence ofcolonic diverticular disease in the total population was 17.3% (26 of 150). The IBS group had a higher prevalence of colonic diverticular disease than the control group with statistical significance (18 of 75, 24.0% in the IBS group vs. 8 of 75 or 10.7% in the control group, p = 0.031). Body mass index (BMI) more than 25 kg/m2, age more than 60 years and being male were associated with colonic diverticular disease without significance (28.1% in BMI >25 kg/m2 vs. 14.3% in BMI ≤25 kg/m2, p = 0.071, 23.0% in age >60 years vs. 13.5% in age ≤60 years, p = 0.132 and 20.3% males vs. 15.1% females, p = 0.406). Type of IBS (IBS-C vs. IBS-D) did not affect the prevalence of colonic diverticular disease (25.8% in IBS-C and 23.1% in IBS-D, p = 0.791). There were no difference in the location of colonic diverticular disease and number ofdiverticuli between the IBS group and control group (p = 0.149 and 0.095)., Conclusion: An increased frequency of colonic diverticular disease was observed in patients with IBS. Increasing age, high BMI and being male were factors associated with colonic diverticular disease. These results suggest that IBS and colonic diverticular disease may have a common pathogenesis.