Rising prevalence of colonic diverticulosis in a westernized multi-ethnic Asian community

Abstract

Background and Aim: Singapore is a multi-ethnic country that has undergone rapid development over the last few decades, with increasing influence of western culture, and faces an aging population. Previously, a varying prevalence of colonic diverticulosis (CD) was reported by a few small studies. This study aims to evaluate the prevalence of CD in Singapore and identify associations with common gastrointestinal symptoms and risk factors. Methods: We reviewed retrospective data of 20 395 consecutive colonoscopies performed from 2006 to 2016 for presence of CD and indications of screening, diarrhea, constipation, and abdominal pain. Results: The prevalence of CD progressively increased from 2006 to 2016 (14.9% vs 23.9%, adjusted trend < 0.001), with an overall prevalence of 19.6%. Patients with CD were older and had higher body mass index (BMI). CD was significantly more prevalent in Chinese compared with Malay and Indian races (20.5% vs 18.9% vs 15.5%, P < 0.05), and in male patients compared with female patients (21.5% vs 17.6%, P < 0.05). Right-sided CD was more common than left-sided or pan diverticulosis (16.2% vs 8.3% vs 4.8%, P < 0.05). Age [odds ratio (OR), 1.060; 95% confidence interval (CI), 1.052–1.068], BMI (OR, 1.051; 95% CI, 1.028–1.075), male gender (OR, 1.317; 95% CI, 1.084–1.600), and abdominal pain (OR, 1.409; 95% CI, 1.168–1.699) were positively associated, while constipation (OR, 0.566; 95% CI, 0.452–0.709) was negatively associated with CD. Conclusion: The prevalence of CD in Singapore has progressively increased over the last decade and is associated with older age, higher BMI, and abdominal pain. These findings may provide insights for healthcare resource planning in the region.