Aggressive Screening for Polyps in Diverticulosis
Patients Appears Unnecessary
Patients with diverticulosis have a lower incidence
of polyps overall, tendency for less-advanced polyps
Oct. 26, 2009 - A Henry Ford Hospital study
questions the need for aggressive screening for colonic polyps in
patients with diverticulosis. About half of senior citizens (those over
age 60) have diverticulosis.
The study sought to determine if asymptomatic
patients with diverticular disease are at higher or lower risk for
developing colonic polyps, abnormal growths found in the wall of the
colon that sometimes become cancerous.
"We found that patients with diverticulosis have a
lower incidence of polyps overall and a tendency for less-advanced
polyps," says Ali Nawras, M.D., chief of Endoscopy Services, Division of
Gastroenterology at Henry Ford Hospital, and lead author of the study.
"These results suggest that for patients with diverticulosis, a
less-aggressive surveillance regimen could be appropriate."
The study results will be presented Oct. 26 at the
American College of Gastroenterology's Annual Scientific Meeting in San
Diego.
Colonic polyps and diverticulosis are common
conditions in Western countries and both diseases share common
predisposing factors such as older age and low-fiber diet. However,
there has been conflicting data on the association between the presence
of diverticulosis and colonic polyps.
According to the National Digestive Diseases
Information Clearing House, about 10 percent of Americans older than 40,
and half of those over age 60, have diverticulosis, a condition where
small pouches in the lining of the colon bulge outward through weak
spots. When the pouches become inflamed, the condition can lead to
bleeding, serious infections, small tears or blockages in the colon.
Henry Ford physicians looked at 1,668 patients, all
who had undergone full colonoscopy and had an average risk for colon
cancer. The case group (899 patients) included those with diverticulosis
and the control group (769 patients) did not.
The incidence of polyps was significantly lower in
the case group, (223, 24%) compared to the control group (336, 43%).
A subanalysis for different polyp sizes and
pathologies was also conducted. Polyps were considered high-risk if they
were greater than 1 cm in size, or had tubulo-villous or cancer
pathology. Subjects with diverticulosis had a significantly lower rate
of high-risk polyps, (36, 4.1%), than those without diverticulosis, (76,
6.8%).
About Diverticulosis and Diverticulitis
Also called: Diverticular disease
Diverticula are small pouches that bulge outward
through the colon, or large intestine. If you have these pouches, you
have diverticulosis. This condition becomes more common as people age.
About half of all people over age 60 have it. Doctors believe the main
cause is a low-fiber diet.
Most people with diverticulosis don't have
symptoms. Sometimes it causes mild cramps, bloating or constipation. A
high-fiber diet and mild pain reliever will often relieve symptoms.
If the pouches become inflamed or infected, you
have diverticulitis. The most common symptom is abdominal pain, usually
on the left side. If the diverticula are infected, you may also have
fever, nausea, vomiting, chills, cramping and constipation. In serious
cases, diverticulitis can lead to bleeding tears, or blockages.
Treatment focuses on clearing up the infection with antibiotics, resting
the colon and preventing future problems. A serious case may require a
hospital stay.
Oct. 26, 2009 - A Henry Ford Hospital study
questions the need for aggressive screening for colonic polyps in
patients with diverticulosis. About half of senior citizens (those over
age 60) have diverticulosis.