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Diverticular disease: update on pathophysiology, classification and management
  1. Sophie Williams1,
  2. Ingvar Bjarnason2,
  3. Bu'Hussain Hayee2,
  4. Amyn Haji1
  1. 1 Department of Colorectal Surgery, King's College Hospital, London, UK
  2. 2 Department of Gastroenterology, King’s College Hospital, London, UK
  1. Correspondence to Sophie Williams, Department of Colorectal Surgery, King's College Hospital, London, SE5 9RS, UK; sophie.williams15{at}


Colonic diverticulosis is prevalent, affecting approximately 70% of the western population by 80 years of age. Incidence is rapidly increasing in younger age groups. Between 10% and 25% of those with diverticular disease (DD) will experience acute diverticulitis. A further 15% will develop complications including abscess, bleeding and perforation. Such complications are associated with significant morbidity and mortality and constitute a worldwide health burden. Furthermore, chronic symptoms associated with DD are difficult to manage and present a further significant healthcare burden. The pathophysiology of DD is complex due to multifactorial contributing factors. These include diet, colonic wall structure, intestinal motility and genetic predispositions. Thus, targeted preventative measures have proved difficult to establish. Recently, commonly held conceptions on DD have been challenged. This review explores the latest understanding on pathophysiology, risk factors, classification and treatment options.


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  • Contributors SW and AH: manuscript conception and writing. SW, IB, BHH and AH: editing and final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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