Isolated Slow Small Bowel Transit Time by Wmc: Defining Patient Population, Clinical Symptoms, and Proximal Small Bowel Pressure Profile

Abstract

Background and Aim: Colonic diverticulitis shows an high recurrence rate. Since no conclusive data are available about the optimal strategy in preventing diverticulitis recurrence, aim of our study was to assess three different therapeutic strategies in preventing diverticulitis recurrence Methods: 130 patients suffering from Acute Uncomplicated Diverticulitis (AUD) (81 Males, 49 Females, mean age 64.71 years, range 40-85) were prospectively assessed during a 2-year follow-up. After obtaining remission, the patients were treatedwithmesalazine 1.6 grams every day (59 patients, group A), or rifaximin 800 mg/day for 7 days every month (52 patients, group B), or did not take any therapy (19 patients, group C). Clinical, endoscopic and histological follow-up was performed after six, 12 and therefore every 12 months after diagnosis of AUD. Results: Fifty-four patients were excluded from final evaluation (see figure 1): 17 patients died; 21 were excluded due to taking unprescribed drugs during the scheduled treatment; 16 were lost to follow-up or were excluded because not compliant. Forty-four group A patients, 23 group B patients, 9 group C patients were available for the final assessment. Sustained remission was statistically higher in group A (93.18%) than group B (56.52%) and group C (44.44%) (A vs B: p=0.01; A vs C: p=0.03; B vs C: p=0.072). Persistence of endoscopic and histological damage were the only factors affecting diverticulitis recurrence. Conclusions: Patients taking mesalazine have lower risk of diverticulitis recurrence than patients taking rifaximin or taking no therapy, thanks to lower prevalence of persisting endoscopic and histological inflammation than in patients taking rifaximin or taking no therapy