Diverticular Disease: Risk Factors and Predictors of the Outcome

Background: Diverticular disease is a common disease which has a considerable burden on health care facilities. Its incidence increases with age and has multifactorial pathogenesis. Objective: To evaluate the predictability of relevant risk factors and the disease process. Design: A Retrospective Study. Setting: King Hamad University Hospital, Bahrain. Method: All patients who were admitted with diverticular disease from 2016 to 2019 were included in the study. We documented the first attack of the disease to test the relevant parameters against the severity and outcome. Disease severity was categorized according to Sallinen VJ et al and P<0.05 was considered significant. Result: One hundred thirty-four patients were included in the study; 76 (56.7%) males and 58 (43.3%) females. The median age was 59.5. One hundred fifteen (85.8%) patients presented with diverticulitis symptoms and 19 (14.2%) with diverticular bleeding. Diverticulitis affected the left colon in 85 (63.4%) patients and 8 (5.9%) on the right colon. Diabetes was associated with advanced stages 4 and 5, P=0.010. In patients with diverticular bleeding, the bleeding stopped spontaneously in 12 (9%), while colonoscopic intervention was required in 7 (5.2%). Conclusion: Diverticulitis affects the left colon while diverticular bleeding commonly occurs in the right colon. Tobacco smoking, aspirin and antithrombotic medications are risk factors for diverticular bleeding. Diabetes is associated with advanced severe diverticulitis presenting with peritonitis.