Relevance of segmental colitis with diverticulosis (SCAD) to other forms of inflammatory bowel disease
A well localized inflammatory process involving only the sigmoid
colonic segment associated with diverticulosis (SCAD), has become
increasingly recognized as a distinct clinical and pathological disorder,
usually described in older adults, often with rectal bleeding. Although
some resolve spontaneously, most patients appear to respond to treatment
only with 5-aminosalicylate. Endoscopic evaluation reveals a
nonspecific inflammatory process localized in the sigmoid colon that
usually completely resolves with histologically normal colonic mucosa.
Recurrent symptoms with evidence of recurrent segmental colitis may
occur, but most have an entirely benign clinical course. Further definition
of the underlying molecular signalling that occurs in this apparently
distinctive disorder may be critically important to understand
the elements of a colonic inflammatory process that can completely
and spontaneously resolve.