Overview
Colonic diverticulitis is a painful gastrointestinal disease characterized by unpredictable recurrence and potential for chronic symptoms 1. It involves inflammation or infection of colonic diverticula 1.Diagnosis
Computed tomography (CT) is often necessary for diagnosis 1.
Colonoscopy after an episode of diverticulitis should be considered based on patient history, prior colonoscopy, and disease severity/course 1.
In patients with a history of diverticulitis and chronic symptoms, imaging and lower endoscopy are recommended to exclude alternative diagnoses 1.Management
Antibiotic treatment can be used selectively rather than routinely in immunocompetent patients with mild acute uncomplicated diverticulitis 1.
Antibiotic treatment is strongly advised in immunocompromised patients 1.
To reduce the risk of recurrence, patients should consume a high-quality diet, maintain a normal body mass index, be physically active, not smoke, and avoid nonsteroidal anti-inflammatory drug (NSAID) use, except for aspirin prescribed for secondary cardiovascular prevention 1.Key Recommendations
Computed tomography is often necessary to make a diagnosis of colonic diverticulitis 1. (Evidence: Expert opinion)
Antibiotic treatment can be used selectively rather than routinely in immunocompetent patients with mild acute uncomplicated diverticulitis 1. (Evidence: Expert opinion)
To reduce the risk of recurrence, patients should consume a high-quality diet, have a normal body mass index, be physically active, not smoke, and avoid nonsteroidal anti-inflammatory drug use except aspirin prescribed for secondary prevention of cardiovascular disease 1. (Evidence: Expert opinion)References
1 Peery AF, Shaukat A, Strate LL. AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review. Gastroenterology 2021. link