A hypothesis: is diverticulitis a type of inflammatory bowel disease?

J Clin Gastroenterol. 2006 Aug;40 Suppl 3:S121-5. doi: 10.1097/01.mcg.0000225502.29498.ba.


It is accepted by epidemiologists that diverticula formation in the colon is related to a deficiency in dietary fiber intake, but the cause of acute diverticulitis remains unknown. A hypothesis is presented that acknowledges from the literature that fiber deficiency is also related to an altered intestinal microecology with a change in the bacterial flora. It is hypothesized that the change in the flora with a decrease in their influence on the immune process permits a low-grade chronic inflammation in the mucosa, which is the first step in developing an acute infection of diverticula or diverticulitis. There is some evidence that the low-grade chronic inflammation is present in subjects with diverticula, which is the forerunner of acute diverticulitis. This hypothesis is strengthened by early reports that anti-inflammatory mucosal agents such as mesalamine and immune process regulators such as probiotics may improve diverticulitis.

MeSH terms

  • Bacteria / growth & development
  • Dietary Fiber / deficiency
  • Diverticulitis, Colonic / immunology*
  • Diverticulitis, Colonic / microbiology
  • Diverticulitis, Colonic / physiopathology
  • Humans
  • Inflammation*
  • Inflammatory Bowel Diseases / immunology*
  • Inflammatory Bowel Diseases / microbiology
  • Inflammatory Bowel Diseases / physiopathology
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / microbiology*
  • Intestinal Mucosa / pathology
  • Intestinal Mucosa / physiopathology