Clin Colon Rectal Surg 2023; 36(02): 146-150
DOI: 10.1055/s-0042-1760676
Review Article

Does Alteration of the Microbiome Cause Diverticular Disease?

Jeffrey L. Roberson
1   Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
,
Lillias M. Maguire
1   Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations

Abstract

The role of the microbiome in influencing the development and course of human disease is increasingly understood and appreciated. In diverticular disease, the microbiome presents an intriguing potential link between the disease and its long-established risk factors, dietary fiber and industrialization. However, current data have yet to demonstrate a clear link between specific alterations in the microbiome and diverticular disease. The largest study of diverticulosis is negative and studies of diverticulitis are small and heterogeneous. Although multiple disease-specific hurdles exist, the early state of the current research and the many un- or underexplored clinical phenotypes present a significant opportunity for investigators to improve our knowledge of this common and incompletely understood disease.



Publication History

Article published online:
17 January 2023

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  • References

  • 1 Isacson D, Smedh K, Nikberg M, Chabok A. Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis. Br J Surg 2019; 106 (11) 1542-1548
  • 2 Daniels L, Ünlü Ç, de Korte N. et al; Dutch Diverticular Disease (3D) Collaborative Study Group. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg 2017; 104 (01) 52-61
  • 3 Burkitt DP, Walker AR, Painter NS. Dietary fiber and disease. JAMA 1974; 229 (08) 1068-1074
  • 4 Klurfeld DM, Davis CD, Karp RW. et al. Considerations for best practices in studies of fiber or other dietary components and the intestinal microbiome. Am J Physiol Endocrinol Metab 2018; 315 (06) E1087-E1097
  • 5 Linninge C, Roth B, Erlanson-Albertsson C, Molin G, Toth E, Ohlsson B. Abundance of Enterobacteriaceae in the colon mucosa in diverticular disease. World J Gastrointest Pathophysiol 2018; 9 (01) 18-27
  • 6 Chen T, Long W, Zhang C, Liu S, Zhao L, Hamaker BR. Fiber-utilizing capacity varies in Prevotella- versus Bacteroides-dominated gut microbiota. Sci Rep 2017; 7 (01) 2594
  • 7 Martens EC, Lowe EC, Chiang H. et al. Recognition and degradation of plant cell wall polysaccharides by two human gut symbionts. PLoS Biol 2011; 9 (12) e1001221
  • 8 Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology 2009; 136 (03) 741-754
  • 9 Strate LL, Morris AM. Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology 2019; 156 (05) 1282-1298.e1
  • 10 Strate LL, Keeley BR, Cao Y, Wu K, Giovannucci EL, Chan AT. Western dietary pattern increases, and prudent dietary pattern decreases, risk of incident diverticulitis in a prospective cohort study. Gastroenterology 2017; 152 (05) 1023-1030.e2
  • 11 Strate LL, Erichsen R, Baron JA. et al. Heritability and familial aggregation of diverticular disease: a population-based study of twins and siblings. Gastroenterology 2013; 144 (04) 736-742.e1 , quiz e14
  • 12 Jones RB, Fodor AA, Peery AF. et al. An aberrant microbiota is not strongly associated with incidental colonic diverticulosis. Sci Rep 2018; 8 (01) 4951
  • 13 van Rossen TM, Ooijevaar RE, Kuyvenhoven JP. et al. Microbiota composition and mucosal immunity in patients with asymptomatic diverticulosis and controls. PLoS One 2021; 16 (09) e0256657
  • 14 Schieffer KM, Sabey K, Wright JR. et al. The microbial ecosystem distinguishes chronically diseased tissue from adjacent tissue in the sigmoid colon of chronic, recurrent diverticulitis patients. Sci Rep 2017; 7 (01) 8467
  • 15 Gueimonde M, Ouwehand A, Huhtinen H, Salminen E, Salminen S. Qualitative and quantitative analyses of the bifidobacterial microbiota in the colonic mucosa of patients with colorectal cancer, diverticulitis and inflammatory bowel disease. World J Gastroenterol 2007; 13 (29) 3985-3989
  • 16 Daniels L, Budding AE, de Korte N. et al. Fecal microbiome analysis as a diagnostic test for diverticulitis. Eur J Clin Microbiol Infect Dis 2014; 33 (11) 1927-1936
  • 17 Cremon C, Bellacosa L, Barbaro MR, Cogliandro RF, Stanghellini V, Barbara G. Diagnostic challenges of symptomatic uncomplicated diverticular disease. Minerva Gastroenterol Dietol 2017; 63 (02) 119-129
  • 18 Altomare A, Gori M, Cocca S. et al. Impaired colonic contractility and intestinal permeability in symptomatic uncomplicated diverticular disease. J Neurogastroenterol Motil 2021; 27 (02) 292-301
  • 19 Barbara G, Scaioli E, Barbaro MR. et al. Gut microbiota, metabolome and immune signatures in patients with uncomplicated diverticular disease. Gut 2017; 66 (07) 1252-1261
  • 20 Tursi A, Mastromarino P, Capobianco D. et al. Assessment of fecal microbiota and fecal metabolome in symptomatic uncomplicated diverticular disease of the colon. J Clin Gastroenterol 2016; 50 (Suppl. 01) S9-S12
  • 21 Kvasnovsky CL, Leong LEX, Choo JM. et al. Clinical and symptom scores are significantly correlated with fecal microbiota features in patients with symptomatic uncomplicated diverticular disease: a pilot study. Eur J Gastroenterol Hepatol 2018; 30 (01) 107-112
  • 22 Lopetuso LR, Petito V, Graziani C. et al. Gut microbiota in health, diverticular disease, irritable bowel syndrome, and inflammatory bowel diseases: time for microbial marker of gastrointestinal disorders. Dig Dis 2018; 36 (01) 56-65