Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-25T15:47:51.228Z Has data issue: false hasContentIssue false
  • English
  • Français

Colonic diverticula

Published online by Cambridge University Press:  05 March 2007

Martin Eastwood
Martin Eastwood*
Affiliation:
Gastrointestinal Unit, Department of Medical Sciences, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
*
*Corresponding author: Dr Martin Eastwood, present address: Hill House, North Queensferry, FifeKY11 1JJ, UK, fax +44 138 341 1124, majeastwood@aol.com
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Diverticulosis is a condition that is associated with ageing. The older the individual the more likely they are to have diverticulosis, but this process is not necessarily inevitable. Diverticula are a herniation through the wall of the sigmoid colon and are likely to be a consequence of a weakness in the colonic wall or prolonged exposure to increased intracolonic pressure consequent on a low dietary fibre intake. The tensile strength of the colon declines with age and becomes least in the distal colon. Adult Africans living in Africa eat a high-fibre diet and are free from diverticulosis. Their colons are stronger, wider and thinner than those Scottish adults of the same age. The strength of the colon is in part dependent on collagen fibres and their diameter. The collagen fibrils on the left side of the colon are smaller and more tightly packed than those of the right side of the colon. Ageing and the presence of colonic diverticulosis are associated with smaller more-tightly-packed collagen fibrils. An animal model was established to investigate the effect of a lifelong high- and low-fibre diet on the development of colonic diverticulosis. The findings show that a high-fibre diet from birth, and preferably a maternal high-fibre diet, lessen the risk of diverticulosis with age.

Keywords

Colonic diverticulosisColon structureCollagen fibrilsDietary fibre
Type
Symposium on ‘Dietary fibre in health and disease’ Session: General aspects of dietary fibre
Information
Proceedings of the Nutrition Society , Volume 62 , Issue 1 , February 2003 , pp. 31 - 36
Copyright
Copyright © The Nutrition Society 2003

References

Barker, DJE, Gluckman, PD, Godfrey, KM, Harding, JE, Owens, JA & Robinson, JS (1993) Foetal nutrition and cardiovascular disease in the adult life. Lancet 341, 938–941.CrossRefGoogle ScholarPubMed
Bornstein, P & Pieze, KA (1966) The nature of the intramolecular cross links in collagen. The separation and characterisation of peptides from the cross link region rat skin collagen. Biochemistry 5, 3460–3473.CrossRefGoogle ScholarPubMed
Burkitt, DP & Trowell, HC (1975) Refined Carbohydrate Foods and Disease. Some Implications of Dietary Fibre. London: Academic PressGoogle Scholar
Christensen, J (1991) Gross and microscopic anatomy of the large intestine. In The Large Intestine Physiology, Pathophysiology and Disease, 13–35 [Phillips, SF, Pemberton, JH, Shorter, RG, editors] New York: Raven Press.Google Scholar
Cleave, TL (1974) The Saccharine Disease. Bristol: Wright.CrossRefGoogle ScholarPubMed
Drummond, H (1917) Sacculi of the large intestine with special reference to their relation to the blood vessels of the bowel wall. British Journal of Surgery 4, 407CrossRefGoogle Scholar
Eastwood, MA (1987) Diverticular disease. In Oxford Textbook of Medicine, 2nd ed. 12.133–12.137 [Weatherall, DJ, Ledingham, JGG, Warrell, DA, editors]. Oxford: Oxford University Press.Google Scholar
Eastwood, MA (1998) Structure and function of the colon. In Encyclopedia of Human Nutrition, 945–953 [Sadler, MJ, Strain, JJ and Caballero, B, editors]. San Diego, CA: Academic Press.CrossRefGoogle Scholar
Epstein, EH & Munderloh, NH (1975) Isolation and characterization of CNBr peptides of human alpha 1 (III) 3 collagen and tissue distribution of alpha 1 (I) 2 alpha 2 and alpha 1 (III) 2 alpha 3 collagen. Journal of Biological Chemistry 250, 9304–9312.CrossRefGoogle Scholar
Ferraz, de & Carvalho, CA (1973) Contribution to the functional study of tubular viscera. Arquivos de Gastroenterologia 10, 183–190.Google Scholar
Flint, MH, Craig, AS, Riley, HC, Gillard, GC & Parry, DAD (1984) Collagen fibril diameters and glycosaminoglycan content of skins – indices of tissue maturity and function. Connective Tissue Research 13, 69–81.CrossRefGoogle ScholarPubMed
Halsted, WS (1891) Intestinal anastamosis. Bulletin of Johns Hopkins Hospital 1, 1–4.Google Scholar
Hodgson, J (1972) An animal model to study diverticular disease. British Journal of Surgery 59, 315–318.Google ScholarPubMed
Painter, NS (1975) Diverticular Disease of the Colon. London: William Heinemann Medical Books Ltd.Google ScholarPubMed
Parry, DAD, Barnes, GRG & Craig, AS (1978) A comparison of the size distribution of collagen fibrils in connective tissues as a function of age and a possible relation between fibril size distribution and mechanical properties. Proceedings of the Royal Society of London 203, 305–321.Google Scholar
Royal College & of Physicians (1980) Medical Aspects of Dietary Fibre 111 – 117 London Pitman MedicalGoogle Scholar
Shepherd, NA (1992) Diverticular disease. In Oxford Textbook of Pathology, pp.1256–1258[McGee, JOD, Isaacson, PG, Wright, NA, editors]. Oxford: Oxford University Press.Google Scholar
Thomson, HJ, Busuttil, A, Eastwood, MA, Smith, AN & Dalton, RA (1986) Submucosa of the human colon. Journal of Ultrastructure and Molecular Structure Research 96, 22–30.CrossRefGoogle ScholarPubMed
Thomson, HG, Busuttil, A, Eastwood, MA, Smith, AN & Elton, RA (1987) Submucosal collagen changes in the normal colon and in diverticular disease. International Journal of Colorectal Disease 20, 208–213.CrossRefGoogle Scholar
Tsuchiya, H & Bates, CJ (1997) Vitamin C and copper interactions in guinea pigs in a study of collagen cross links. British Journal of Nutrition 11, 315–325.CrossRefGoogle Scholar
Walters, DAK, Smith, AN, Eastwood, MA, Anderson, KC, Elton, RA & Mugerwa, JW (1985) Mechanical properties of the colon: comparison of the features of the African and European colon in vitro. Gut 26, 384–392.CrossRefGoogle Scholar
Wess, L, Eastwood, M, Busuttil, A, Edwards, C & Millar, A (1996a) An association between maternal diet and colonic diverticulosis in an animal model. Gut 39, 423–27.CrossRefGoogle ScholarPubMed
Wess, L, Eastwood, MA, Edwards, CA, Busuttil, A & Miller, A (1996b) Collagen alterations in an animal model of colonic diverticulosis. Gut 38, 701–706.CrossRefGoogle Scholar
Wess, L, Eastwood, MA, Wess, TJ, Busuttil, A & Miller, A (1995) Cross linkage of collagen is increased in colonic diverticulosis. Gut 37, 91–94.CrossRefGoogle ScholarPubMed
Yamade, MABA (1970) Strength of Biological Materials. Baltimore, MD: Williams and Watkins.Google Scholar