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 |