Colonic Motility in the Pathogenesis of Diverticular Disease

Diverticular disease is the fifth most common gastrointestinal disease, which poses a significant economic burden, especially on the aging western population. The pathogenesis of diverticular disease is multifactorial. It results from complex interactions between various dietary, anatomic, neurochemical, and neuromuscular factors that affect the colon. There is consistent evidence that diverticular disease is associated with high intraluminal pressures, stronger segmental and propagated contractions, and increased colonic motor activity both at rest and after provocations such as a meal, especially in the colonic segments that are affected by diverticulosis. These changes are likely to be mediated by structural and neurochemical alterations of the enteric nervous system. Whether disturbed colonic motility is the cause or the effect of a process that culminates in diverticular disease remains to be fully understood.