Colonic diverticular disease. Treatment and prevention.

Abstract

Diverticular disease represents the most common disease affecting the colon in the Western world. Most cases remain asymptomatic, but some others will have symptoms or develop complications. The aims of treatment in symptomatic uncomplicated diverticular disease are to prevent complications and reduce the frequency and intensity of symptoms. Fibre, probiotics, mesalazine, rifaximin and their combinations seem to be usually an effective therapy. In the uncomplicated diverticulitis, outpatient management is considered the optimal approach in the majority of patients, and oral antibiotics remain the mainstay of treatment. Admission to hospital and intravenous antibiotic are recommended only when the patient is unable to intake food orally, affected by severe comorbidity or does not improve. However, inpatient management and intravenous antibiotics are necessary in complicated diverticulitis. The role of surgery is also changing. Most diverticulitis-associated abscesses can be treated with antibiotics and/or percutaneous drainage and emergency surgery is considered only in patients with acute peritonitis. Finally, patient related factors, and not the number of recurrences, play the most important role in selecting recipients of elective surgery to avoid recurrences.

• Authors: Carla J Gargallo Puyuelo, Federico Sopeña, Angel Lanas Arbeloa
• Journal: Gastroenterologia y hepatologia (Gastroenterol Hepatol) Vol. 38 Issue 10 Pg. 590-9 (Dec 2015) ISSN: 0210-5705 [Print] Spain
• PMID: 25979437 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Anti-Inflammatory Agents, Non-Steroidal
• Dietary Fiber
• Gastrointestinal Agents
• Parasympatholytics
• Vitamin D
• Mesalamine

Topics

• Anti-Bacterial Agents (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Combined Modality Therapy
• Contraindications
• Dietary Fiber (therapeutic use)
• Diverticulitis, Colonic (drug therapy, etiology, prevention & control, surgery)
• Diverticulosis, Colonic (complications, physiopathology, prevention & control, therapy)
• Gastrointestinal Agents (therapeutic use)
• Humans
• Intestinal Fistula (etiology, prevention & control)
• Mesalamine (therapeutic use)
• Parasympatholytics (therapeutic use)
• Peritonitis (etiology, prevention & control)
• Probiotics (therapeutic use)
• Vitamin D (therapeutic use)