Diverticulitis in Younger Populations

Widely considered a disease of the elderly, since incidence increases steadily with age, acute diverticulitis now seems to be on the rise in younger urban populations.

Diverticular disease is when small sac-like out-pouchings of the inner bowel lining push through the outer muscle wall of the colon. Called diverticula, these pockets occur most frequently in the lower part of the colon. Diverticulitis occurs when the pockets become inflamed.

As reported in the American Journal of Roentgenology, researchers reviewed the medical records of 104 adult patients with both radiological evidence and a clinical diagnosis of acute diverticulitis. While previous reports demonstrated a low incidence, between 2% and 5%, in populations younger than 40 years old, this new study found that 54% were younger than 50 years, and 21% were younger than 40 years. As noted in prior studies, there was a strong link between this disease and obesity, and this relationship was somewhat more marked in younger patients.

This demographic change is important to note since there is also a slightly higher risk of recurrent episodes in younger patients who have a potentially longer span of living with the illness. Consequently, this study encourages radiologists to consider acute diverticulitis more often when making a differential diagnosis of abdominal pain in younger patients.

The best preventative action against diverticulitis is a well-balanced, high-fibre diet beginning as early on in life as possible. Gradual introduction of fibre into the diet is essential. The primary way that increased fibre helps is by reducing incidents of constipation that put pressure on the lower colon. Studies show that fruits and vegetables appear to offer more protection than cereal fibres. There also seems to be a similar protective effect from physical activity. However, a high intake of total fat and red meat may increase the risk of the disease.

First published in the Inside Tract® newsletter issue 165 – January/February 2008
Zaidi E, Daly B. CT and clinical features of acute diverticulitis in an urban US population: rising frequency in young, obese adults. American Journal of Roentgenology. 2006; 187:689-694.