Conservative Treatment of Acute Colonic Diverticulitis

Overview

Journal Curr Infect Dis Rep

Specialty Infectious Diseases

Date 2017 Sep 25

PMID 28942590

Citations 7

Authors

S T van Dijk

S J Rottier

A A W van Geloven

M A Boermeester

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Since the treatment of acute diverticulitis has become more conservative over the last years, knowledge of conservative treatment strategies is increasingly important.

Recent Findings: Several treatment strategies that previously have been imposed as routine treatment are now obsolete. Uncomplicated diverticulitis patients can be treated without antibiotics, without bed rest, and without dietary restrictions; and a selected group of patients can be treated as outpatients. Also, patients with isolated pericolic extraluminal air can be treated conservatively as well. Whereas some patient subgroups have been suggested to suffer from a more virulent disease course or higher recurrence rates, current evidence does not support all traditional understandings. Patients on immunosuppression or non-steroidal anti-inflammatory drugs seem to have a higher risk of complicated diverticulitis, but young patients do not. Data on the risk of recurrent diverticulitis in young patients is conflicting but the risk seems comparable to elderly patients. Besides the traditional treatments, several new treatment strategies have emerged but have failed thus far. Mesalazine does not have any beneficial effect on preventing recurrent diverticulitis based on current literature. Rifaximin and probiotics have been studied insufficiently in acute diverticulitis patients to conclude on their efficacy. This review provides an overview of recent developments in conservative treatment strategies of acute diverticulitis and discusses the latest evidence on patient subgroups that have been suggested to suffer from an aberrant disease course.

Citing Articles

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Diverticular Disease and Rifaximin: An Evidence-Based Review.

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Identifying patients with complicated diverticulitis, is it that complicated?.

Imam A, Steiner E, Imam R, Omari L, Lin G, Khalayleh H Turk J Surg. 2022; 38(2):169-174.

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Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence.

Ma Z, Liu W, Zhou J, Yao L, Xie W, Su M BMC Surg. 2022; 22(1):132.

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Acute Diverticulitis in Young Patients: A Review of the Changing Epidemiology and Etiology.

Turner G, OGrady M, Purcell R, Frizelle F Dig Dis Sci. 2021; 67(4):1156-1162.

PMID: 33786702 DOI: 10.1007/s10620-021-06956-w.

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