Review Article: The Pathogenesis of Diverticular Disease - Current Perspectives on Motility and Neurotransmitters
Résumé
Background: Low fibre diet, structural abnormalities and ageing are traditional aetiological factors implicated in the development of Diverticular Disease (DD). More recently, motility disorders are implicated in its causation leading to speculation that neurotransmitters play a role in mediating these disturbances. Aims: To draw together studies on the role of neurotransmitters in the development of DD and its symptoms. Methods: Medline, GoogleScholar and Pubmed were searched for evidence on this subject using the terms neurotransmitters, motility, Diverticular Disease and pathogenesis. Articles relevant to the subject were cited and linked references also reviewed. Results: Serotonin which has been found to be an excitatory colonic neurotransmitter has been found in early studies to be increased in colonic enterochromaffin cells. Acetylcholine which is thought to be an excitatory neurotransmitter and cholinergic activity has also seen to be increased in DD. These findings may suggest that an increase in excitatory neurotransmitters may result in the hypersegmentation thought to cause pulsion diverticula. Similarly, a decrease of Nitric Oxide which is inhibitory is found Conclusions: There is some evidence that neurotransmitters may play a role in the motility disturbances seen in DD however a clear role is yet to be ascertained.
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