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Ulcerative Colitis and Diverticular Disease
Ulcerative colitis is not only a disease of young people, it can start in a high age. In old age, diverticular disease of the sigmoideum is quite common, and sometimes colonoscopy reveales two diseases. This old lady in her ninth decade got bloody diarrhea and anaemia. This colonoscopy picture taken in the distal descendent colon shows diverticular disease.
In this picture 45 cm from the anus, the mucosa gets red and fragile.
And this picture from the middle of the sigmoid colon shows both diverticulas (but no diverticulitis!) and a mucosal change typical of ulcerative colitis.
So this old lady has a diverticular disease (probably for decades) and a concommittant ulcerative colitis. Probably there are no association between these two diseases. A few months later, all the symtoms were gone after and during treatment with sulfasalazin.
Antonio Rispo et al (http://www.springerlink.com/content/e5884577n154176h/) has studied the prevalence of diverticulosis in 85 patients with ulcerative colitis and older than 45 years, compared to the prevalence in people without ulcerative colitis. Patients with ulcerative colitis had a significant lower prevalence of diverticulosis (7 of 85) compared to controls (24 of 85). All seven patients with both ulcerative colitis and diverticulosis had been diagnosed with ulcerative colitis when older than 45, making it probable that the diverticular disease had developed before the patients got ulcerative colitis. The reason why patients with ulcerative colitis do not develop colonic diverticulas is probably the motor alterations caused by chronic bowel wall inflammation.
Ulcerative colitis and diverticulosis
Some excellent books - if You want to know more about inflammatory bowel diseases:
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