Abdominal pain in patients with
diverticular disease (DD) can be challenging in clinical practice. Patients with symptomatic uncomplicated
diverticular disease (SUDD) and patients with a previous acute
diverticulitis (PD) may share a similar clinical pattern, difficult to differentiate from
irritable bowel syndrome (IBS). We used standardized questionnaires for DD (short and long lasting
abdominal pain) and IBS (following Rome III Criteria) to assess clinical features of
abdominal pain, in terms of presence, severity and length, in SUDD and PD patients. One hundred and forty-eight SUDD and 118 PD patients completed all questionnaires. Short-lasting
pain was more frequent in SUDD than PD patients (p = 0.007). Number of long-lasting
pain episodes was higher in SUDD (6.6 ± 11.9) compared to PD patients (3.4 ± 6.9) (p < 0.001). PD patients reported long-lasting
pain more frequently in the lower left abdomen (p < 0.001), while in SUDD it was more frequently diffuse (p = 0.002) or localized in the lower right quadrant (p = 0.009). Features associated with long-lasting
pain (
fever, confinement to bed, consultations,
antibiotic therapy, hospitalization) were more often reported in PD patients. IBS criteria were reported in 28.2% of patients and were more frequent in SUDD than PD patients (37.2% vs 17.1%, p < 0.001). SUDD and PD patients presented different pattern of
abdominal pain (length, number of long lasting episodes, site and associated features), with a third reporting overlap with IBS. Further observational studies are needed to better characterize abdominal symptoms in DD patients, especially in those not fulfilling IBS criteria.Trial registration: The REMAD Registry is registered as an observational study in ClinicalTrial.gov (ID: NCT03325829).