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Purpose: In 1995, the Health Professionals Follow-up Study published an isolated report of lower diverticular disease risk in physically active men, particularly among those who ran. The purpose of this article was to assess whether this finding can be verified among older men and women of the National Runners' Health Study., Methods: Survival analyses were applied to incident disease occurring during 7.7 yr of follow-up in 9072 men and 1664 women, representing 84% follow-up of the original >or=50-yr-old cohort. In addition to the usual running distance (km x d(-1)), 80% of the baseline respondents included 10-km footrace performance times (a measure of cardiorespiratory fitness). Results were adjusted for age, sex, and reported intakes of meat, fish, fruit, and alcohol., Results: A total of 127 men and 21 women reported clinically diagnosed diverticular disease since baseline. The risk for incident diverticular disease decreased 6.2% per km x d(-1) run (P = 0.04). Relative to men and women who ran 8 km x d(-1) had 48% lower risk (P = 0.05). Each meter-per-second increment in the 10-km performance was associated with a 68% risk reduction (P = 0.04). Men and women who ran >4 m x s(-1) had 70% lower risk for diverticular disease than those who ran

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, occurring in 2-3% of the population. Enterolith formation associated with MD is a rare entity. We present the case of a 35-year-old active duty sailor who presented with a 24-hour history of worsening abdominal pain and nausea. His exam revealed lower abdominal peritonitis. An abdominal and pelvic CT scan revealed a fluid-filled structure in the pelvis adjacent to the distal small bowel with associated calcifications. Exploratory laparotomy was performed, which revealed an acutely inflamed MD associated with enterolith formation. Consideration of this condition in the differential upon presentation of an acute abdomen is essential, secondary to the morbidity that can accompany it when misdiagnosed.

Diverticular disease is a common entity in the USA with an apparent increasing incidence worldwide. The pathogenesis of this disease process is likely multifactorial involving dietary habits, changes in colonic pressures and motility, and colon wall structural changes associated with aging. The following review addresses our current limited knowledge regarding the epidemiology and pathogenesis of diverticulosis and diverticulitis.