A new analysis of more than 5.2 million hospitalizations shows a worrying rise in severe diverticulitis among Americans under 50. The study, led by researchers from UCLA and Vanderbilt University, was published in Diseases of the Colon & Rectum and examined hospital admissions for adult diverticulitis patients in the U.S. from 2005 to 2020.
The researchers found that the proportion of younger adults hospitalized with complicated diverticulitis—a form involving abscesses, perforations, or other serious complications—increased from 18.5% to 28.2%, a 52% relative rise. This trend mirrors similar increases seen in colorectal cancer among younger adults, raising public health concerns.
“Severe diverticulitis has traditionally been viewed as a disease of older adults, but our data shows younger Americans are increasingly affected, often with more complex cases,” said Shineui Kim, first author and medical student at UCLA. Co-author Dr. Aimal Khan emphasized that this shift highlights a growing burden among a population previously considered at low risk.
Diverticulitis occurs when small pouches form in weak areas of the colon wall, causing abdominal pain, bloating, constipation, diarrhea, or bleeding. Using the National Inpatient Sample, the researchers found that of the 837,195 early-onset cases, hospitalizations for complicated diverticulitis rose significantly.
Despite the increase in complicated cases, the study found that surgical intervention rates have declined, with colectomy rates among younger patients dropping from 34.7% to 20.3%, reflecting more effective conservative management. Younger patients also had lower mortality, shorter hospital stays, and reduced costs per admission. However, they were more likely than older patients to require invasive procedures, including surgery or percutaneous drainage, suggesting more aggressive disease or differing treatment approaches.
The study underscores the need for further research to determine why severe diverticulitis is rising in younger adults. Potential factors include dietary habits, lifestyle changes, obesity, or environmental influences, but clear causes remain uncertain.
