Demographic and clinical features distinguish subgroups of diverticular disease patients: Results from an Italian nationwide registry

Background: Clinical features and lifestyle factors associated with diverticulosis compared to diverticular disease (DD), either symptomatic uncomplicated diverticular disease (SUDD) or in patients who have had previous diverticulitis (PD), are unclear. Objective: The objective of this article is to compare cross-sectionally demographic and clinical features and quality of life (QoL) in diverticulosis, SUDD and PD patients. Methods: The REMAD Registry is a prospective, observational, multicentre, cohort study. Patients were categorised according to: diverticulosis; SUDD (recurrent abdominal symptoms attributed to diverticula in absence of overt inflammation) and PD (≥1 previous diverticulitis). Results: A total of 1217 patients (57.9% diverticulosis, 24.7% SUDD and 17.4% PD) were included. Compared to diverticulosis, female gender was associated to SUDD (OR 1.94; 95% CI: 1.43–2.62) and PD (OR 1.79; 95% CI: 1.24–2.56); age ≤ 60 years was associated to PD (OR 2.10; 95% CI: 1.42–3.08 vs diverticulosis, OR 1.57; 95% CI: 1.01–2.45 vs SUDD). PD patients showed an association with past bleeding (OR 29.29; 95% CI: 8.17–104.98 vs diverticulosis, OR 16.84; 95% CI: 3.77–75.25 vs SUDD). Compared to diverticulosis, family history for diverticula was associated to PD (OR 1.88; 95% CI: 1.27–2.78). Patients with diverticulosis showed higher QoL scores, both physical (p = 0.0001 and 0.0257) and mental (p < 0.0001 and 0.0038), in comparison to SUDD and PD. Conclusion: Family history for diverticula and history of bleeding distinguish diverticulosis from DD. These clinical features should be kept in mind in the management of DD.