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Incidence increases with age in Western societies
5% at age < 40
30% at age 60
50% at age > 80
Uncommon in developing countries
Most are asymptomatic, discovered incidentally at endoscopy or on barium enema
Causes
Diet deficient in fiber
Ehlers-Danlos syndrome
Marfan syndrome
Scleroderma
The extent to which abnormal motility and hereditary factors contribute to diverticular disease is unknown
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Nonspecific complaints
Chronic constipation
Abdominal pain
Fluctuating bowel habits
Whether these symptoms are due to alterations in the colonic motility, visceral hypersensitivity, gut microbiota, or low-grade inflammation is unclear
Physical examination usually normal
Complications occur in 33%, including lower GI bleeding and diverticulitis
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Routine laboratory studies normal
Diverticula best seen on barium enema and CT imaging
Colonoscopy less sensitive than barium enema
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Patients should increase dietary fiber either through diet (fruits, vegetables, whole grains) or fiber supplements (psyllium, methylcellulose)
Exercise and avoiding red meat and nonsteroidal anti-inflammatory drugs may be helpful