Factors associated with the development of IBS-like symptoms in patients with colon diverticula: a case-control study

Abstract

Objective. The purpose of the research is to study the development factors of irritable bowel syndrome (IBS) in patients with colonic diverticulosis (CD). 

Materials and methods. A one-center observational prospective study was conducted in 185 patients with asymptomatic diverticulosis (group 1) and 178 patients without diverticula of the colon (group 2). All patients underwent colonoscopy and Heim test to identify the individual coping strategies. During a 5-year follow-up, IBS symptoms were reported according to Roman criteria IV. 

Results. Group1patients developed significantly more (p< 0.001) inflammatory changes in the colon mucosa according to the index of low-grade histological activity in sigmoid and descending colon (61% and 19%) as compared to group 2 patients (4% and 0%). The cumulative "survival" for IBS symptoms in patients without diverticula was higher than in patients with CD. IBS-symptoms were significantly more common in patients with CD and depended on the location of diverticulosis. 

Conclusion. Low-grade inflammation of the colon mucosa is an independent predictor of IBS-like symptoms. Nonadaptive coping strategies predominate in patients with IBS symptoms, regardless of the presence of CD.