173 The Fecal Microbiome in Diverticulitis and Uncomplicated Diverticulosis

Abstract

Backgorund: Colonic diverticulitis shows a high recurrence rate, but the role of fecal markers in predicting recurrence is unknown. The aim of this study was to investigate the role of fecal calprotectin (FC) in predicting recurrence of diverticulitis. Materials and methods: A prospective cohort study was performed on 54 patients suffering from Acute Uncomplicated Diverticulitis (AUD). After remission, patients underwent to clinical follow-up every 2 months. During the follow-up, C-reactive protein (CRP) and FC was analysed at each medical control visit starting 2 weeks after the end of the antibiotic therapy. Recurrence of diverticulitis was defined as return to our observation due to left lower quadrant pain with or without other symptoms (e.g. fever), associated with leucocytosis and/or increased CRP, and confirmed by means of CT. Results: The mean follow-up was 20 months (range 12-24 months). Fortyeight patients were available for the final evaluation, and 6 patients were lost to follow-up. During the follow-up, increased FC was detected in 17 (35.4%) patients. Diverticulitis recurred in 8 (16.7%) patients: 7 (87.5%) patients showed increased FC during the followup, and only 1 (12.5%) patient with recurrent diverticulitis didn't show increased FC. FC sensitivity, specificity, positive predictive value and negative predictive value were 87.5%, 75.0%, 41.2%, and 96.8%, respectively. Only higher FC values (>60 μg/g) correlated with CRP levels (rho=0.351, 95%CI 0.163 to 0.5267; p=0.001). Finally, extension of diverticulosis showed correlation with FC expression (rho=0.632, 95% CI 0.515 to 0.791; p=0.000). Conclusions: Increased FC was found to be predictive of diverticulitis recurrence. Accuracy of fecal calprotectin (FC) test for the diagnosis of recurrent diverticulitis.