Potential risk factors in diverticular perforation classified by biological mechanisms of action
| Mecahnism of action | Pathway | Risk factors |
|---|---|---|
| Raised intracolonic pressure | Altered autonomic activity | Decreased physical exercise25,26 |
| Prostigmine/neostigmine27,28 | ||
| Opioid receptors | Opioid drugs21,29–31 | |
| Reduced mechanical stretching of colon | Fibre deficiency32,33 | |
| Impaired mucosal barrier | Altered microbial colonisation | Antibiotics34,35 |
| Fibre deficiency36 | ||
| Altered mucin secretion | NSAIDs37–39 | |
| Fibre deficiency40–42 | ||
| Damaged epithelial cells | NSAIDs37–39 | |
| Red meat43,44 | ||
| Decreased immune response | Corticosteroids and other immunosuppressants45 | |
| Advanced age46 |