The relationship of obesity to the complications of diverticular disease

Objective Diverticular disease is common in our community. Most patients remain asymptomatic and the development of diverticular complications is rare. A common clinical observation is that patients presenting with complications of diverticular disease are obese. The aim of this study was to examine the relationship of obesity to the complications of diverticular disease. Methods The study was based on a retrospective case note review conducted at the Flinders Medical Centre between 1/7/1998 and 30/6/2003. Patients were identified using ICD codes and their body mass index (BMI) calculated. Controls were taken randomly from the colonoscopy database at The Flinders Medical Centre. Patients were divided into four groups, those admitted with diverticular perforation or abscess, recurrent diverticulitis, a single episode of diverticulitis and a control group of patients with uncomplicated diverticulosis. The mean BMI for each group was calculated. Statistical analysis was performed by one way ANOVA test with significance set at P < 0.05. Results Sixty-one patients were studied, including 16 patients with perforated diverticular disease, 11 randomly selected Nvith recurrent diverticulitis, 16 patients with a single episode of diverticulitis and 13 controls. The control group had a significantly lower BMI than patients presenting with perforation (P = 0.001) or recurrent diverticulitis (P = 0.002). There was no significant difference between the control group and patients with a single episode of diverticulitis (P = 1.0). Conclusion The study showed that patients with perforations and recurrent diverticulitis are significantly more obese than those who remain asymptomatic or have one episode. The aetiological relationship between obesity and diverticular complications remain unclear.