[Diverticular disease - new insights into pathogenesis].
Thilo Wedel, Martina Barrenschee, François Cossais, Christina Lange, Martina Böttner
Author Information
Thilo Wedel: Arbeitsgruppe Neurogastroenterologie, Zentrum für Klinische Anatomie, Anatomisches Institut, Christian-Albrechts-Universität zu Kiel.
Martina Barrenschee: Arbeitsgruppe Neurogastroenterologie, Zentrum für Klinische Anatomie, Anatomisches Institut, Christian-Albrechts-Universität zu Kiel.
François Cossais: Arbeitsgruppe Neurogastroenterologie, Zentrum für Klinische Anatomie, Anatomisches Institut, Christian-Albrechts-Universität zu Kiel.
Christina Lange: Arbeitsgruppe Neurogastroenterologie, Zentrum für Klinische Anatomie, Anatomisches Institut, Christian-Albrechts-Universität zu Kiel.
Martina Böttner: Arbeitsgruppe Neurogastroenterologie, Zentrum für Klinische Anatomie, Anatomisches Institut, Christian-Albrechts-Universität zu Kiel.
Diverticular disease is associated with a high incidence, morbidity and burden of the healthcare system. However, the pathogenesis is not yet satisfactorily clarified and thought to be multifactorial. Non-influenceable risk factors include increasing age, genetic predisposition and rare congenital connective tissue diseases. Influenceable risk factors are low-fiber diet, increased meat consumption and obesity. Alterations of connective tissue lead to a weakening of preformed emergence sites of diverticula ("loci minoris resistentiae") and may explain the increased incidence of diverticular disease in diseases caused by a systematic connective tissue disorder. The impact of neuromuscular alterations and disturbed colonic motility on triggering diverticula formation has been previously underestimated. Moreover, intestinal innervation disorders are considered to be responsable for persisting recurrent pain symptoms in chronic diverticular disease.
