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Abdominal Pain in the News

Disease of older adults now seen in young, obese adults

Acute diverticulitis, a disease traditionally seen in patients older than 50 years old, is now being seen in younger adults who are obese, according to a study conducted by the University of Maryland Medical Center's department of radiology in Baltimore, MD.

Acute diverticulitis is one of the most frequently encountered acute diseases of the colon and is commonly related to a low fiber diet. Increased pressure in the colon causes numerous thin-walled out-pouches (diverticula) to develop in the bowel wall, a chronic condition known as diverticulosis. Bacterial infection of these diverticula cause inflammation that may lead to a perforation in the wall of the intestine and other serious complications.

"Over the last ten years, I noted that many patients coming into the emergency room with CT findings of acute diverticulitis seemed younger than traditional teaching suggested, and often were obese," said Barry Daly, MD, an author of the study. "We were seeing patients as young as their early twenties, though textbooks typically describe this condition as a disease of the over-fifty age group," he said.

The study group was composed of 104 patients, both men and women, broken into two age groups: 50 years old or younger and older than 50 years. Abdominal obesity was present and more severe in 85.7% of the 50 years or younger group compared with 77% of the older patients.

"There is clearly an association with abdominal obesity in these younger patients. Obese adult patients are at risk for this disease after twenty years of age," said Dr. Daly. "Because patients who get acute diverticulitis always have underlying diverticulosis of the colon, younger patients may be at increased risk for recurrent attacks of inflammation of these diverticula over the long term," he said.

"For physicians it is important to add acute diverticulitis to the list of diseases that may cause acute abdominal pain in younger patients who come to the emergency room, especially if they are obese. Radiologists should be aware of this possibility when evaluating CT scans of these patients," said Dr. Daly.