Prevalence of Segmental Colitis Associated With Colic Diverticulosis (SCAD)
Prevalence of Segmental Colitis Associated With Colic Diverticulosis (SCAD)
Colonic diverticula are common in Western countries, affecting up to 60% of subjects over 70
 years of age. In about 80% of patients, colonic diverticula remain asymptomatic
 (diverticulosis), while approximately 20% of patients may develop abdominal symptoms
 (symptomatic uncomplicated diverticular disease, SUDD) and, eventually, complications such as
 bouts of diverticulitis or bleeding.

 A small proportion of patients with colonic diverticulosis may develop segmental colitis
 associated with diverticulosis (SCAD). SCAD is separate clinical disease with specific
 macroscopic (erythema, friability and ulcerations) and microscopic features characterized by
 chronic, mucosal inflammation involving the inter-diverticular mucosa (usually sigmoid colon)
 sparing the proximal colon and rectum colon.

 The most common symptoms of SCAD are rectal bleeding, diarrhoea and abdominal pain.

 To achieve SCAD diagnosis a correct biopsies sampling is mandatory. It is necessary to take
 biopsies on the borders of the diverticula and in the apparently normal adjacent mucosa as
 well as biopsies in both the colon proximal to the diverticular area and the rectum in order
 to exclude chronic inflammatory bowel disease. The spectrum of histological lesions
 associated with SCAD is variable, including mild non-specific inflammation and inflammatory
 bowel disease (IBD)-like changes.

 Currently, data regarding prevalence of SCAD are scarce. It has been estimated that in
 patients with diverticulosis, SCAD prevalence ranged from 0.3-1.3%.

 The aim of the present study is to assess prospectively the prevalence of segmental colitis
 associated with colon diverticulosis (SCAD), in consecutive patients with colic
 diverticulosis, in a tertiary university centre.
Inclusion Criteria:

 -  Endoscopic finding of colonic diverticulosis associated with macroscopic signs of
 inflammation (erythema, friability and ulcerations) of the interdiverticular mucosa

 Exclusion Criteria:

 -  inability to sign informed consent;

 -  impossibility to perform biopsies during colonoscopy (e.g. anticoagulant therapy/
 conditions predisposing to high risk of bleeding);

 -  Diagnosis of chronic inflammatory bowel disease.