(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays.)
By Nancy Lapid
(Reuters) -Serious cases of a disorder of the large intestine are surging among Americans younger than 50, researchers say.
Analyzing data on more than 5.2 million adults hospitalized for diverticulitis from 2005 to 2020, they found that the proportion of patients under age 50 admitted with serious complications increased from 18.5% to 28.2%.
Furthermore, patients under age 50 who were hospitalized for diverticulitis were more likely to require invasive procedures, with 29% higher odds of needing surgery to remove part of the colon and 58% higher odds of requiring insertion of a catheter to drain infected fluid, compared to their older counterparts, the researchers reported in Diseases of the Colon and Rectum.
Diverticulitis occurs when food particles, bacteria, and other debris accumulate in small pouches that have formed on weak areas on the wall of the colon, leading to abdominal pain, bloating, bleeding, constipation and diarrhea. In complicated cases, patients may develop abscesses and holes in the colon.
Until now, diverticulitis has been considered more common among older adults. It affects fewer than 20% of people by age 40, increases to 35% to 40% by age 50, and reaches about 60% by age 60, according to U.S. data. In the oldest age groups, the prevalence can exceed 70%.
“We’re seeing a significant shift in who is being hospitalized for severe diverticulitis,” study leader Shineui Kim of the David Geffen School of Medicine at UCLA said in a statement.
The findings point to a growing public health concern for younger Americans, with this population having experienced similar increases in colorectal cancer diagnoses, the researchers said.
Treatments have improved, they noted, with the proportion of younger patients requiring surgical removal of part of the colon decreasing from 34.7% to 20.3% during the study period.
The researchers said the potential causes of the rising burden of early-onset diverticulitis require further research.
EDWARDS HEART VALVE REPLACEMENT EFFECTIVE IN LOWER-RISK PATIENTS
A minimally-invasive procedure to replace the heart’s aortic valve is just as safe and effective as open-heart surgery for patients healthy enough to have opted for the more intensive treatment, a long-term study confirms.
The international trial involved 1,000 relatively healthy patients who were randomly assigned to undergo heart valve replacement using Edwards Lifesciences’ Sapien 3 transcatheter aortic valve replacement (TAVR) system, or open-heart surgery. They all had aortic stenosis, a severe narrowing of the valve that restricts blood flow to the body.
When it was approved in Europe in 2007 and the U.S. in 2011, TAVR was recommended only for patients who were considered too frail to undergo open-heart surgery, which was the standard of care. TAVR involves threading the valve into place through an artery and has been associated with shorter hospital stays than chest cracking open-heart surgery.
Healthier patients such as those in the current study were typically advised instead to opt for the surgery rather than the newer method.
Seven years into the study, health outcomes for patients were similar regardless of which procedure they had undergone, researchers reported in The New England Journal of Medicine and at the TCT interventional cardiology meeting in San Francisco.
Composite rates of death, stroke or rehospitalization related to treatment were 34.6% after TAVR and 37.2% after surgery, a difference that was not statistically significant.
Rates of valve failure were also similar, at 6.9% for TAVR and 7.3% for surgery.
Patients in the two groups reported comparable quality of life outcomes.
The researchers plan to report on these patients again after 10 years have elapsed since their procedures.
“Since low-risk patients are generally younger, long-term follow-up to assess late clinical outcomes and valve durability are needed to inform lifetime patient-care decisions,” they said.
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(Reporting by Nancy Lapid; Editing by Bill Berkrot)
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