Diverticular Disease
Diverticular Disease
Diverticulitis is thought to be more virulent in younger patients, with 25% to 80% reportedly requiring urgent surgery during their initial attack. The recurrence rate also has been reported to be higher in younger patients in older studies. American College of Gastroenterology practice guidelines for diverticular disease state that elective (prophylactic) surgery after one episode of uncomplicated diverticulitis may be reasonably considered in younger patients based on both the low surgical risk of an elective procedure in a healthy young person and the many years of future risk of recurrence.
More recent studies have challenged the view that diverticulitis is more virulent in younger patients and the recommendation for surgical intervention after an initial event. Anaya and Flum found that although there was an increased relative risk for emergency colectomy or colostomy in younger patients, the absolute risk was low. These investigators found that 73% of younger patients had no recurrence and most resolved without surgery. Their work showed that a policy of routine elective colectomy in a younger population would require 13 elective surgeries to prevent 1 emergency colectomy.
Diverticulitis in Younger Patients
Diverticulitis is thought to be more virulent in younger patients, with 25% to 80% reportedly requiring urgent surgery during their initial attack. The recurrence rate also has been reported to be higher in younger patients in older studies. American College of Gastroenterology practice guidelines for diverticular disease state that elective (prophylactic) surgery after one episode of uncomplicated diverticulitis may be reasonably considered in younger patients based on both the low surgical risk of an elective procedure in a healthy young person and the many years of future risk of recurrence.
More recent studies have challenged the view that diverticulitis is more virulent in younger patients and the recommendation for surgical intervention after an initial event. Anaya and Flum found that although there was an increased relative risk for emergency colectomy or colostomy in younger patients, the absolute risk was low. These investigators found that 73% of younger patients had no recurrence and most resolved without surgery. Their work showed that a policy of routine elective colectomy in a younger population would require 13 elective surgeries to prevent 1 emergency colectomy.