PubMed · 14890305
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1951. CHRONIC ulcerative colitis.. https://pubmed.ncbi.nlm.nih.gov/14890305/
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BACKGROUND: Diverticulosis is associated with high intracolonic pressure and a weakened bowel wall. Chronic colitis is characterized by liquid stools suggestive of low intracolonic pressure and a thickened bowel wall. Therefore, the aim of this study was to assess the prevalence of diverticulosis in colitis patients. METHODS: Colonoscopy results of patients with inflammatory bowel disease (IBD)-associated colitis older than 50 years were retrospectively evaluated and compared with those of patients who underwent screening colonoscopy. Only patients with biopsy-proven disease, disease duration of more than 5 years, and disease beyond the distal 20 cm were included. RESULTS: In all, 1037 patients were diagnosed by colonoscopy as suffering from IBD-associated colitis between 1987-2005. After exclusion of patients who did not meet the inclusion criteria the study population consisted of 314 IBD patients and 1023 age-matched control patients. A significantly higher percent of diverticuli was detected in the control group compared with the IBD group (15% versus 3.5%, P < 0.001). No significant difference in the prevalence of diverticuli was detected between the three subtypes of IBD patients (2% in ulcerative colitis versus 4.7% in Crohn's colitis versus 7.6% in indeterminant colitis). Neither disease duration nor the specific colonic segment involved had a significant influence on the prevalence of diverticulosis. CONCLUSIONS: Long-standing colonic inflammation in IBD patients is associated with a lower prevalence of diverticuli.
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When patients with inflammatory bowel disease (IBD) are admitted to the hospital with a flare of acute severe colitis, the possibility of a concurrent cytomegalovirus (CMV) infection causing or worsening the colitis is often considered. IBD patients are usually immunosuppressed, and therefore presumably at increased risk for active CMV infection and disease. Multiple techniques are used to diagnose CMV infection, including endoscopy, histology, serology, viral culture, CMV antigen testing, and CMV DNA testing. Immunohistochemistry (IHC) performed on colon biopsy specimens with monoclonal antibodies directed against CMV immediate early antigen is considered by most to be the current gold standard for diagnosis. The prevalence of CMV infection in acute severe colitis appears to be 21-34%, and the prevalence of CMV infection in the steroid refractory subgroup of these patients is 33-36%. After antiviral therapy, colitis remission rates in IBD patients with CMV infection range from 67% to 100%, though CMV histological infection or the presence of circulating virus alone is not always associated with steroid resistance, and may not require antiviral therapy.