Pilot study: MRI study of Diverticular disease symptoms and its relationship to visceral adipose tissue (Obesity Study)
1st April 2010
Team: Professor Robin Spiller.
Colonic diverticulosis is a condition in which pockets form on the large bowel wall. They are very common and affect 5% of people in their 5th decade and up to 66% of the elderly population in the United Kingdom. Complications can occur with the pockets, including inflammation (diverticulitis) and bleeding. It is responsible for substantial morbidity with 68,000 hospital admissions recorded per year in the UK and it contributes to about 2,000 deaths. Up to a third of patients may also suffer from recurrent episodes of pain. Unfortunately, current treatments are not often effective.
There is increasing evidence that obesity is linked to complications of diverticular disease. Recent studies have also suggested that patients with a higher body mass index (BMI) are more likely to have pain, develop a perforation, recurrent episodes of diverticulitis or a diverticular bleed. Patients under 40 years with diverticular disease complications also tend to have a higher BMI. This agrees with our own studies at the Nottingham.
With the incidence of obesity and diverticular disease increasing in westernised populations, the risk of complications from diverticular disease is likely to increase. However there is little understanding of how obesity increases diverticular complications. We hypothesize that increased visceral fat, as assessed by MRI, and the associated fall in adiponectin, will correlate with increased immune activation within the bowel which will be associated with reduced small bowel water. This will in turn be associated with symptoms especially pain and days with diarrhoea in symptomatic diverticular disease patients.
By doing these studies we hope to be able to understand the link between obesity and diverticular complications and hence how to reduce them.