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It is widely known that in Western countries left-sided diverticular disease is common, whereas in Japan right-sided diverticular disease is more frequent. Intraluminal pressure in the ascending colon of thirteen patients with right-sided diverticular disease and of ten normal subjects was studied with Mikro-Tip pressure transducer inserted through a colonoscope in order to investigate the pathogenesis of right-sided diverticular disease. In the resting state the colonic motility index of patients with rightsided diverticular disease was greater than that of controls. After intravenous injection of neostigmine methylsulfate higher pressure waves were more frequently observed in patients with diverticular disease than in controls and the colonic motility index of patients with diverticular disease was much greater than that of controls with statistical significance. There was no difference in colonic motility between asymptomatic and symptomatic patients with right-sided diverticular disease, whereas the colonic motility index of asymptomatic patients with diverticular disease was significantly greater than that of controls both in the resting state and in the neostigmine stimulated state. These intraluminal pressure waves were generated by segmental contractions which did not transfer barium in the ascending colon distally. From these observations it is suggested that high intraluminal pressure and the abnormal motility in the ascending colon play an important role in the pathogenesis of right-sided diverticular disease.