vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2020.4.3vmireaviz-79Research ArticleКлиническая медицинаClinical medicineДивертикулярная болезнь толстого кишечника: современное состояние проблемыDiverticular disease of the large intestine: current state of the problemЛысовН. А.LysovN. A.

Лысов Николай Александрович - доктор медицинских наук, профессор, ректор

Самара

Samara

ОсадчукМ. М.OsadchukM. M.

Осадчук Максим Михайлович - кандидат медицинских наук, доцент кафедры клинической медицины; заведующий отделом организационно-методической и клинико-экспертной работы

Самара

Москва

Samara

Moscow

БалашовД. В.BalashovD. V.

Балашов Дмитрий Владимирович - кандидат медицинских наук, Главный врач

Москва

Moscow

Частное учреждение образовательная организация высшего образования «Медицинский университет Реавиз»РоссияPrivate institution educational organization of higher education "Medical University ReaviesRussian FederationЧастное учреждение образовательная организация высшего образования «Медицинский университет Реавиз»; ГБУЗ г. Москвы «Городская поликлиника № 52 Департамента здравоохранения города Москвы»РоссияPrivate institution educational organization of higher education "Medical University Reavies; GBUZ of Moscow «City Polyclinic № 52 of the Moscow Department of Health»Russian FederationГБУЗ г. Москвы «Городская поликлиника № 52 Департамента здравоохранения города Москвы»РоссияGBUZ of Moscow «City Polyclinic № 52 of the Moscow Department of Health»Russian Federation202031122020043341Copyright © Лысов Н.А., Осадчук М.М., Балашов Д.В., 20202020Лысов Н.А., Осадчук М.М., Балашов Д.В.Lysov N.A., Osadchuk M.M., Balashov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/79

В данном обзоре приведены современные сведения об этиопатогенезе, клинике, диагностике и лечении дивертикулярной болезни толстого кишечника (ДБТК). На основании проведенного анализа и эпидемиологических данных данную патологию можно отнести к глобальной эпидемии 21 века, ассоциированной с вестернизацией образа жизни и постарением населения в цивилизованных странах. Описанная тактика ведения больных с данной патологией базируется на мировых тенденциях, сформировавшихся в последнее десятилетие.

This review presents modern information on etiopathogenesis, clinic, diagnostics and treatment of diverticular disease of the large intestine (DBTK). Based on the analysis and epidemiological data, this pathology can be attributed to the global epidemic of the 21st century, associated with the Westernization of lifestyle and aging of the population in civilized countries. The described tactics of management of patients with this pathology is based on global trends that have formed in the last decade.

дивертикулярная болезнь толстой кишкидивертикулитрифаксиминмесалазинdiverticular disease of the colondiverticulitisrifaximinemesalazineReferencesPeery A.F., Crockett S.D., Murphy C.C. et al. Burden and cost of gastrointes-tinal, liver, and pancreatic diseases in the United States: update 2018. Gas-troenterology. 2019; 156:254–272.e11.Peery A.F., Crockett S.D., Murphy C.C. et al. Burden and cost of gastrointes-tinal, liver, and pancreatic diseases in the United States: update 2018. Gas-troenterology. 2019; 156:254–272.e11.Osadchuk M.A., Svistunov A.A., Zolotovitskaya A.M. and others. Diverticular disease of the large intestine and its association with polyps and colorectal cancer: clinical-instrumental and immunomorphological research // North Cau-casus Medical Newsletter. – 2020. – № 1. – С. 52–57.Osadchuk M.A., Svistunov A.A., Zolotovitskaya A.M. and others. Diverticular disease of the large intestine and its association with polyps and colorectal cancer: clinical-instrumental and immunomorphological research // North Cau-casus Medical Newsletter. – 2020. – № 1. – С. 52–57.Everhart J.E., Ruhl C.E. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology. 2009;136:741–754.Everhart J.E., Ruhl C.E. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology. 2009;136:741–754.Michael Camilleri, Robert S. Sandler, Anne F. Peery. Etiopathogenetic Mecha-nisms in Diverticular Disease of the Colon. Cell Mol Gastroenterol Hepatol. 2020; 9(1): 15–32. Published online 2019 Jul 25. doi: 10.1016/j.jcmgh.2019.07.007 PMCID: PMC6881605Michael Camilleri, Robert S. Sandler, Anne F. Peery. Etiopathogenetic Mecha-nisms in Diverticular Disease of the Colon. Cell Mol Gastroenterol Hepatol. 2020; 9(1): 15–32. Published online 2019 Jul 25. doi: 10.1016/j.jcmgh.2019.07.007 PMCID: PMC6881605Rafferty J, Shellito P, Hyman NH, Buie WD. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. 2006;49(7):939–44. doi: 10.1007/s10350-006-0578-2.Rafferty J, Shellito P, Hyman NH, Buie WD. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. 2006;49(7):939–44. doi: 10.1007/s10350-006-0578-2.Nguyen GC, Sam J, Anand N. Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States. World J Gastro-enterol. 2011;17(12):1600–1605.Nguyen GC, Sam J, Anand N. Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States. World J Gastro-enterol. 2011;17(12):1600–1605.Etzioni DA, Mack TM, Beart RW, Jr, et al. Diverticulitis in the United States: 1998–2005: Changing patterns of disease and treatment. Ann Surg 2009; 249: 210–217.Etzioni DA, Mack TM, Beart RW, Jr, et al. Diverticulitis in the United States: 1998–2005: Changing patterns of disease and treatment. Ann Surg 2009; 249: 210–217.Delvaux M. Diverticular disease of the colon in Europe: Epidemiology, impact on citizen health and prevention. Aliment PharmacolTher 2003; 18: S71–S74.Delvaux M. Diverticular disease of the colon in Europe: Epidemiology, impact on citizen health and prevention. Aliment PharmacolTher 2003; 18: S71–S74.Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, Gemmen E, Shah S, Avdic A, Rubin R. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–1511.Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, Gemmen E, Shah S, Avdic A, Rubin R. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–1511.Alatise OI, Arigbabu AO, Agbakwuru EA, et al. Spectrum of colonoscopy find-ings in Ile-Ife Nigeria. Niger Postgrad Med J 2012; 19: 219–224.Alatise OI, Arigbabu AO, Agbakwuru EA, et al. Spectrum of colonoscopy find-ings in Ile-Ife Nigeria. Niger Postgrad Med J 2012; 19: 219–224.Strate L. L. Diverticulosis and dietary fiber: rethinking the relationship. Gastroenterology 142, 205–207 (2012).Strate L. L. Diverticulosis and dietary fiber: rethinking the relationship. Gastroenterology 142, 205–207 (2012).Meurs-Szojda M. M., Terhaar sive Droste J. S., Kuik D. J.,Mulder C. J. J., Felt-Bersma R. J. F. Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies. Int. J. Colorectal. Dis.2008;23(10):979-984. https://doi.org/10.1007/s00384-008-0510-4Meurs-Szojda M. M., Terhaar sive Droste J. S., Kuik D. J.,Mulder C. J. J., Felt-Bersma R. J. F. Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies. Int. J. Colorectal. Dis.2008;23(10):979-984. https://doi.org/10.1007/s00384-008-0510-4Regula J. Diverticular Disease and Colorectal Cancer: Incidental Diagnosis or Real Association? Final Answer. J. Clin. Gastroenterol. 2016;50 Suppl.1:S39-40.https://doi.org/10.1097/MCG.0000000000000643Regula J. Diverticular Disease and Colorectal Cancer: Incidental Diagnosis or Real Association? Final Answer. J. Clin. Gastroenterol. 2016;50 Suppl.1:S39-40.https://doi.org/10.1097/MCG.0000000000000643Jansen A. Risk factors for colonic diverticular bleeding: A westernized com-munity-based hospital study. World J Gastroenterol 2009; 15: 457–457Jansen A. Risk factors for colonic diverticular bleeding: A westernized com-munity-based hospital study. World J Gastroenterol 2009; 15: 457–457Jansen A. Risk factors for colonic diverticular bleeding: A westernized com-munity-based hospital study. World J Gastroenterol 2009; 15: 457–457Jansen A. Risk factors for colonic diverticular bleeding: A westernized com-munity-based hospital study. World J Gastroenterol 2009; 15: 457–457Strate L.L., Morris A.M. Epidemiology, pathophysiology, and treatment of di-verticulitis. Gastroenterology. 2019;156:1282–1298.e1.Strate L.L., Morris A.M. Epidemiology, pathophysiology, and treatment of di-verticulitis. Gastroenterology. 2019;156:1282–1298.e1.Daniels L., Philipszoon L.E., Boermeester M.A. A hypothesis: important role for gut microbiota in the etiopathogenesis of diverticular disease. Dis Colon Rectum. 2014;57:539–543.Daniels L., Philipszoon L.E., Boermeester M.A. A hypothesis: important role for gut microbiota in the etiopathogenesis of diverticular disease. Dis Colon Rectum. 2014;57:539–543.Nguyen L.H., Cao Y., Ma W., Jovani M., Liu P.-H., Huttenhower C., Ludvigsson J.F., Wu K., Giovannucci E., Strate L.L., Chan A.T. Chronic antibiotic use and subsequent development of diverticulitis. Gastroenterology. 2019;156(Suppl 1):S1155.Nguyen L.H., Cao Y., Ma W., Jovani M., Liu P.-H., Huttenhower C., Ludvigsson J.F., Wu K., Giovannucci E., Strate L.L., Chan A.T. Chronic antibiotic use and subsequent development of diverticulitis. Gastroenterology. 2019;156(Suppl 1):S1155.Walker MM, Harris AK. Pathogenesis of diverticulosis and diverticular dis-ease. Minerva GastroenterolDietol. 2016 Dec 14.Walker MM, Harris AK. Pathogenesis of diverticulosis and diverticular dis-ease. Minerva GastroenterolDietol. 2016 Dec 14.Wedel T, Barrenschee M, Lange C, Cossais F, Böttner M. Morphologic Basis for Developing Diverticular Disease, Diverticulitis, and Diverticular Bleeding. Viszeralmedizin. 2015 Apr;31(2):76-82. doi: 10.1159/000381431. Review.Wedel T, Barrenschee M, Lange C, Cossais F, Böttner M. Morphologic Basis for Developing Diverticular Disease, Diverticulitis, and Diverticular Bleeding. Viszeralmedizin. 2015 Apr;31(2):76-82. doi: 10.1159/000381431. Review.Scarpignato C, Barbara G, Lanas A, et al. Management of colonic diverticular disease in the third millennium: Highlights from a symposium held during the United European Gastroenterology Week 2017. Therap Adv Gastroenterol 2018; 11: 1756284818771305–1756284818771305.Scarpignato C, Barbara G, Lanas A, et al. Management of colonic diverticular disease in the third millennium: Highlights from a symposium held during the United European Gastroenterology Week 2017. Therap Adv Gastroenterol 2018; 11: 1756284818771305–1756284818771305.Tursi A, Elisei W, Giorgetti GM, et al. Inflammatory manifestations at colon-oscopy in patients with colonic diverticular disease. AlimentPharmacolTher 2011; 33: 358–365.Tursi A, Elisei W, Giorgetti GM, et al. Inflammatory manifestations at colon-oscopy in patients with colonic diverticular disease. AlimentPharmacolTher 2011; 33: 358–365.Diverticular disease of the large intestine / A.A. Svistunov, M.A. Osadchuk, D.V. Bala-shev, M.M. Osadchuk. – M.: RAMS Publishing House, 2017. – 52 р.Diverticular disease of the large intestine / A.A. Svistunov, M.A. Osadchuk, D.V. Bala-shev, M.M. Osadchuk. – M.: RAMS Publishing House, 2017. – 52 р.Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study. Antonio Tursi,corresponding author / G. Brandimarte [et al.] // United European Gastroenterol J. 2016 Aug; 4(4): 604–613.Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study. Antonio Tursi,corresponding author / G. Brandimarte [et al.] // United European Gastroenterol J. 2016 Aug; 4(4): 604–613.Tursi A, Brandimarte G, Di Mario F, et al. Development and validation of an endoscopic classification of diverticular disease of the colon: The DICA classification. DigDis 2015; 33: 68–76.Tursi A, Brandimarte G, Di Mario F, et al. Development and validation of an endoscopic classification of diverticular disease of the colon: The DICA classification. DigDis 2015; 33: 68–76.Gallo A1, Ianiro G, Montalto M, Cammarota G. The Role of Biomarkers in Diver-ticular Disease. J ClinGastroenterol. 2016 Oct;50 Suppl 1:S26-8. doi: 10.1097/MCG.0000000000000648.Gallo A1, Ianiro G, Montalto M, Cammarota G. The Role of Biomarkers in Diver-ticular Disease. J ClinGastroenterol. 2016 Oct;50 Suppl 1:S26-8. doi: 10.1097/MCG.0000000000000648.Tursi A. New physiopathological and therapeutic approaches to diverticular disease: An update. ExpertOpinPharmacother 2014; 15: 1005–1017.Tursi A. New physiopathological and therapeutic approaches to diverticular disease: An update. ExpertOpinPharmacother 2014; 15: 1005–1017.Cuomo R, Barbara G, Andreozzi P, et al. Symptom patterns can distinguish di-verticular disease from irritable bowel syndrome. Eur J Clin Invest 2013; 43: 1147–1155.Cuomo R, Barbara G, Andreozzi P, et al. Symptom patterns can distinguish di-verticular disease from irritable bowel syndrome. Eur J Clin Invest 2013; 43: 1147–1155.Bevan R, Lee TJ, Nickerson C, et al. Non-neoplastic findings at colonoscopy after positive faecal occult blood testing: Data from the English Bowel Can-cer Screening Programme. J Med Screen 2014; 21: 89–94Bevan R, Lee TJ, Nickerson C, et al. Non-neoplastic findings at colonoscopy after positive faecal occult blood testing: Data from the English Bowel Can-cer Screening Programme. J Med Screen 2014; 21: 89–94Scarpignato C, Barbara G, Lanas A, et al. Management of colonic diverticular disease in the third millennium: Highlights from a symposium held during the United European Gastroenterology Week 2017. Therap Adv Gastroenterol 2018; 11: 1756284818771305–1756284818771305.Scarpignato C, Barbara G, Lanas A, et al. Management of colonic diverticular disease in the third millennium: Highlights from a symposium held during the United European Gastroenterology Week 2017. Therap Adv Gastroenterol 2018; 11: 1756284818771305–1756284818771305.Carabotti M, Annibale B. Treatment of diverticular disease: An update on lat-est evidence and clinical implications. Drugs Context 2018; 7: 212526–212526.Carabotti M, Annibale B. Treatment of diverticular disease: An update on lat-est evidence and clinical implications. Drugs Context 2018; 7: 212526–212526.Carmelo Scarpignato, Giovanni Barbara, Angel Lanas, Lisa L. Strate. Manage-ment of colonic diverticular disease in the third millennium: Highlights from a symposium held during the United European Gastroenterology Week 2017. Therap Adv Gastroenterol. 2018; 11: 1756284818771305. Published online 2018 May 20. doi: 10.1177/1756284818771305Carmelo Scarpignato, Giovanni Barbara, Angel Lanas, Lisa L. Strate. Manage-ment of colonic diverticular disease in the third millennium: Highlights from a symposium held during the United European Gastroenterology Week 2017. Therap Adv Gastroenterol. 2018; 11: 1756284818771305. Published online 2018 May 20. doi: 10.1177/1756284818771305Tandon A, Fretwell VL, Nunes QM, et al. Antibiotics versus no antibiotics in the treatment of acute uncomplicated diverticulitis - a systematic review and meta-analysis. Colorectal Dis. Epub ahead of print 11 January 2018. DOI: 10.1111/codi.14013Tandon A, Fretwell VL, Nunes QM, et al. Antibiotics versus no antibiotics in the treatment of acute uncomplicated diverticulitis - a systematic review and meta-analysis. Colorectal Dis. Epub ahead of print 11 January 2018. DOI: 10.1111/codi.14013Gargallo Puyuelo CJ, Sopena F, Lanas Arbeloa A. Colonic diverticular disease. Treatment and prevention. Gastroenterol Hepatol 2015; 38: 590–599.Gargallo Puyuelo CJ, Sopena F, Lanas Arbeloa A. Colonic diverticular disease. Treatment and prevention. Gastroenterol Hepatol 2015; 38: 590–599.Barbara G, Cremon C, Barbaro MR, et al. Treatment of diverticular disease with aminosalicylates: the evidence. J Clin Gastroenterol 2016; 50(Suppl. 1): S60–S63.Barbara G, Cremon C, Barbaro MR, et al. Treatment of diverticular disease with aminosalicylates: the evidence. J Clin Gastroenterol 2016; 50(Suppl. 1): S60–S63.Barbara G, Scaioli E, Barbaro MR, et al. Gut microbiota, metabolome and im-mune signatures in patients with uncomplicated diverticular disease. Gut 2017; 66: 1252–1261.Barbara G, Scaioli E, Barbaro MR, et al. Gut microbiota, metabolome and im-mune signatures in patients with uncomplicated diverticular disease. Gut 2017; 66: 1252–1261.Humes DJ, Spiller RC. Review article: the pathogenesis and management of acute colonic diverticulitis. Aliment Pharmacol Ther 2014; 39: 359–370.Humes DJ, Spiller RC. Review article: the pathogenesis and management of acute colonic diverticulitis. Aliment Pharmacol Ther 2014; 39: 359–370.Cuomo R, Barbara G, Annibale B. Rifaximin and diverticular disease: position paper of the Italian Society of Gastroenterology (SIGE). Dig Liver Dis 2017; 49: 595–603.Cuomo R, Barbara G, Annibale B. Rifaximin and diverticular disease: position paper of the Italian Society of Gastroenterology (SIGE). Dig Liver Dis 2017; 49: 595–603.Italian consensus conference for colonic diverticulosis and diverticular dis-ease. Rosario Cuomo,corresponding author1 Giovanni Barbara,2 Fabio Pace,3 Vi-to Annese,4 Gabrio Bassotti,5 Gian Andrea Binda,6 Tino Casetti,7 Antonio Colecchia,2 Davide Festi,2 Roberto Fiocca,8 Andrea Laghi,9 Giovanni Maconi,10 Riccardo Nascimbeni,11 Carmelo Scarpignato,12 Vincenzo Villanacci,13 and Bru-no Annibale14. United European Gastroenterol J. 2014 Oct; 2(5): 413–442. doi: 10.1177/2050640614547068Italian consensus conference for colonic diverticulosis and diverticular dis-ease. Rosario Cuomo,corresponding author1 Giovanni Barbara,2 Fabio Pace,3 Vi-to Annese,4 Gabrio Bassotti,5 Gian Andrea Binda,6 Tino Casetti,7 Antonio Colecchia,2 Davide Festi,2 Roberto Fiocca,8 Andrea Laghi,9 Giovanni Maconi,10 Riccardo Nascimbeni,11 Carmelo Scarpignato,12 Vincenzo Villanacci,13 and Bru-no Annibale14. United European Gastroenterol J. 2014 Oct; 2(5): 413–442. doi: 10.1177/2050640614547068Strate L.L., Liu Y.L., Aldoori W.H., et al. Physical activity decreases di-verticular complications. Am JGastroenterol 2009; 104:1221-30.Strate L.L., Liu Y.L., Aldoori W.H., et al. Physical activity decreases di-verticular complications. Am JGastroenterol 2009; 104:1221-30.Strate L.L., Liu M.S., Aldoori W.H., et al. Obesity increases the risk of di-verticulitis and diverticular bleeding. Gastroenterology 2009; 136(1):115-22.Strate L.L., Liu M.S., Aldoori W.H., et al. Obesity increases the risk of di-verticulitis and diverticular bleeding. Gastroenterology 2009; 136(1):115-22.

The authors declare that there are no conflicts of interest present.