A novel endoscopic grading system for prediction of disease-related outcomes in patients with diverticulosis

Abstract Background We describe a simple endoscopic grading system of diverticular disease for the assessment of disease severity and prediction of outcomes. Methods A retrospective analysis of prospectively maintained colonoscopy database was conducted. A single endoscopist prospectively graded disease severity according to the number and size of diverticula, the degree of muscular hypertrophy and rigidity of the sigmoid colon. Results 762 patients were included in the analysis. Mean patient age was 70 years (range 37–97). Endoscopic severity of diverticulosis was predictive of the need for surgery, with 2% in the mild-moderate, 12% in the severe and 33% in the acute group (p  Conclusion Surgeons should consider using endoscopic grading as an adjunct to clinical management decisions.