ĭifferences in diverticular disease between Western and Asian countries The prevalence of diverticulosis according to the Clinical Outcomes Research Initiative National Endoscopy Database was 33% in individuals 50–59 years old and 71% in those older than 80 years. The prevalence of diverticulosis was 35% in those younger than 50 years, 40% in individuals 50–59 years old, and 58% in those older than 60 years. Participants with diverticula were more likely to be older and male moreover, they had a higher body mass index and waist circumference than those without diverticula. In one prospective study of 624 individuals undergoing screening colonoscopy in the United States, 260 (42%) had colonic diverticulosis. Diverticula were located only in the sigmoid colon in 65% of patients and in other parts of the colon, along with the sigmoid colon, in 24% of patients they were equally distributed throughout the colon in 7% of patients and were located in a segment proximal to the sigmoid colon in 4% of patients. Approximately 95% of patients with diverticulosis had diverticula in the sigmoid colon.

This increase has been most notable among young individuals. Prior studies have shown an increase in the prevalence of diverticulosis from the mid-1990s through the early part of the current century. Western countries have prevalence rates of 5–45% for diverticulosis, depending on the method of diagnosis and the age of the population (Table 1). The distribution and clinical characteristics of colonic diverticulosis, diverticulitis, and diverticular bleeding, in addition to the differences in presentation between Western and Asian countries, are reviewed in this article. However, the prevalence of diverticulosis, diverticulitis, and diverticular bleeding in Western countries is different from that in Asian countries. Furthermore, the incidence of diverticular disease appears to be increasing with aging. Therefore, it is associated with a significant economic burden in terms of health-care costs, hospitalization, and resource utilization not only in Western but also in Asian countries. Diverticular disease is responsible for a high number of gastrointestinal admissions and clinical visits. The incidence of diverticular disease is increasing over time in both Western and Asian countries. Diverticular disease is defined as clinically significant and symptomatic diverticulosis complicated by diverticulitis, diverticular bleeding, segmental colitis associated with diverticula, or symptomatic uncomplicated diverticular disease these are the so-called complications of colonic diverticulosis. The prevalence of colonic diverticulosis is increasing in Western and Asian countries. Therefore, diverticular disease is associated with a significant economic burden in terms of health-care costs and resource utilization. Diverticular disease with complications requires admission and operation moreover, it recurs frequently. Diverticular bleeding is predominantly located on the right side in Western countries, and both-sided diverticulosis increases the risk of bleeding in Asian countries. Key Messages: In Western countries, diverticulosis and diverticulitis are predominantly located on the left side of the colon, whereas they are predominantly present on the right side of the colon in Asian countries. In Asian countries, age greater than 70 years and both-sided diverticulosis increase the bleeding risk. The right colon is the source of diverticular bleeding in more than 50% of patients in Western countries. The incidence of diverticular bleeding also increases with age. The overall complication rate is higher in left-sided than in right-sided diverticulitis. Diverticulitis is predominantly located on the left side of the colon in Western countries, while it is predominantly located on the right side of the colon in Asian countries. The incidence of diverticulitis also increases with age. Most cases of diverticulosis in Western countries involve the left side of the colon, while diverticulosis is predominantly present on the right side of the colon in Asian countries. Summary: The incidence of diverticulosis increases with age. Diverticular disease is a burdensome digestive disease, because it is a major cause of hospital admissions and is associated with significant health-care costs. Diverticulosis can be complicated by diverticulitis and diverticular bleeding. Background: Colonic diverticulosis is prevalent and increasing not only in Western but also in Asian countries.

Intestinal flexture