Diverticulitis treatment

diverticulitis treatment

Medical Care

The approach to the treatment of diverticulitis can be broadly classified into either uncomplicated disease or complicated disease, with a few other special considerations to take into account. Acute uncomplicated diverticulitis is successfully treated in 70-100% of patients with conservative management. [9, 10]

Activity

Author

Kamyar Shahedi, MD Clinical Instructor, Olive View-UCLA Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Yuvrajsinh Narendrasinh Chudasama, MD Staff Physician, Department of Internal Medicine, Olive View-UCLA Medical Center; Assistant Clinical Professor of Medicine, University of California, Los Angeles, David Geffen School of Medicine

Yuvrajsinh Narendrasinh Chudasama, MD is a member of the following medical societies: American College of Physicians and American Medical Association

Disclosure: Nothing to disclose.

Stanley K Dea, MD Chief of Endoscopy, Acting Chief of Gastroenterology, Consulting Gastroenterologist Olive View-University of California at Los Angeles Medical Center; Director of Enteral Feeding, West Los Angeles Veterans Affairs Medical Center; Director of Endoscopic Training, University of California at Los Angeles Affiliated Training Program in Gastroenterology

Disclosure: Nothing to disclose.

Andrea Cooperman, MD Assistant Clinical Professor of Medicine, David Geffen School of Medicine at UCLA, Olive View-UCLA Medical Center

Andrea Cooperman, MD is a member of the following medical societies: Alpha Omega Alpha and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Marc D Basson, MD, PhD, MBA, FACS Professor of Surgery, Assistant Dean for Faculty Development in Research, Director, Program for Surgical and Biomedical Research, Michigan State University College of Human Medicine

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

Disclosure: Nothing to disclose.

Additional Contributors

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

Disclosure: Nothing to disclose.

David Greenwald, MD Associate Professor of Clinical Medicine, Fellowship Program Director, Department of Medicine, Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

Norvin Perez, MD Medical Director, Juneau Urgent and Family Care

Disclosure: Nothing to disclose.

Waqar A Qureshi, MD Associate Professor of Medicine, Chief of Endoscopy, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine and Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Ahmed Sherif, MD Staff Physician, Department of Internal Medicine, Montefiore Medical Center

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

www.worldgastroenterology.org/diverticular-disease.html. Accessed 10 June 2011.

Karatepe O, Gulcicek OB, Adas G, et al. Cecal diverticulitis mimicking acute appendicitis: a report of 4 cases. World J Emerg Surg. Apr 21 2008;3:16. [Medline]. [Full Text].

Shahedi K, Fuller G, Bolus R, et al. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clin Gastroenterol Hepatol. Dec 2013;11(12):1609-13. [Medline].

Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL. Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology. Jan 2009;136(1):115-122.e1. [Medline]. [Full Text].

Shahedi K, Fuller G, Bolus R, et al. Progression from Incidental Diverticulosis to Acute Diverticulitis. Gastroenterol. May 2012;142(5) Suppl 1:S-144. [Full Text].

Strate LL, Modi R, Cohen E, Spiegel BM. Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights. Am J Gastroenterol. Oct 2012;107(10):1486-93. [Medline].

Lahat A, Avidan B, Sakhnini E, Katz L, Fidder HH, Meir SB. Acute Diverticulitis: A Decade of Prospective Follow-up. J Clin Gastroenterol. Jan 16 2013;[Medline].

Miller FH, Bree RL, Rosen MP, et al. Expert Panel on Gastrointestinal Imaging. ACR Appropriateness Criteria left lower quadrant pain. [online publication]. Reston (VA): American College of Radiology (ACR); 2008:[Full Text].

Ricciardi R, Baxter NN, Read TE, Marcello PW, Hall J, Roberts PL. Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis. Dis Colon Rectum. Sep 2009;52(9):1558-63. [Medline].

Alonso S, Pera M, Pares D, et al. Outpatient treatment of patients with uncomplicated acute diverticulitis. Colorectal Dis. Nov 10 2009;[Medline].

Trivedi CD, Das KM. Emerging therapies for diverticular disease of the colon. J Clin Gastroenterol. Nov-Dec 2008;42(10):1145-51. [Medline].

Stollman N, Magowan S, Shanahan F, Quigley EM. A Randomized Controlled Study of Mesalamine After Acute Diverticulitis: Results of the DIVA Trial. J Clin Gastroenterol. Feb 18 2013;[Medline].

[Guideline] Rafferty J, Shellito P, Hyman NH, Buie WD. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. Jul 2006;49(7):939-44. [Medline]. [Full Text].

Riansuwan W, Hull TL, Millan MM, Hammel JP. Nonreversal of Hartmann's procedure for diverticulitis: derivation of a scoring system to predict nonreversal. Dis Colon Rectum. Aug 2009;52(8):1400-8. [Medline].

Fleming FJ, Gillen P. Reversal of Hartmann's procedure following acute diverticulitis: is timing everything. Int J Colorectal Dis. Oct 2009;24(10):1219-25. [Medline].

Rink AD, John-Enzenauer K, Haaf F, et al. Laparoscopic-assisted or laparoscopic-facilitated sigmoidectomy for diverticular disease? A prospective randomized trial on postoperative pain and analgesic consumption. Dis Colon Rectum. Oct 2009;52(10):1738-45. [Medline].

Crowe FL, Appleby PN, Allen NE, Key TJ. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ.

Jul 19 2011;343:d4131. [Medline]. [Full Text].

Ambrosetti P, Robert JH, Witzig JA, Mirescu D, Mathey P, Borst F, et al. Acute left colonic diverticulitis in young patients. J Am Coll Surg. Aug 1994;179(2):156-60. [Medline].

Bahadursingh AM, Virgo KS, Kaminski DL, Longo WE. Spectrum of disease and outcome of complicated diverticular disease. Am J Surg. Dec 2003;186(6):696-701. [Medline].

Bordeianou L, Hodin R. Controversies in the surgical management of sigmoid diverticulitis. J Gastrointest Surg. Apr 2007;11(4):542-8. [Medline].

Broderick-Villa G, Burchette RJ, Collins JC, Abbas MA, Haigh PI. Hospitalization for acute diverticulitis does not mandate routine elective colectomy. Arch Surg. Jun 2005;140(6):576-81; discussion 581-3. [Medline].

Caterino JM, Emond JA, Camargo CA Jr. Inappropriate medication administration to the acutely ill elderly: a nationwide emergency department study, 1992-2000. J Am Geriatr Soc. Nov 2004;52(11):1847-55. [Medline].

Chapman J, Davies M, Wolff B, Dozois E, Tessier D, Harrington J, et al. Complicated diverticulitis: is it time to rethink the rules. Ann Surg. Oct 2005;242(4):576-81; discussion 581-3. [Medline].

Dominguez EP, Sweeney JF, Choi YU. Diagnosis and management of diverticulitis and appendicitis. Gastroenterol Clin North Am. Jun 2006;35(2):367-91. [Medline].

Evans JP, Cooper J, Roediger WE. Diverticular colitis - therapeutic and aetiological considerations. Colorectal Dis. May 2002;4(3):208-212. [Medline].

Ferzoco LB, Raptopoulos V, Silen W. Acute diverticulitis. N Engl J Med. May 21 1998;338(21):1521-6. [Medline].

Floch MH, White JA. Management of diverticular disease is changing. World J Gastroenterol. May 28 2006;12(20):3225-8. [Medline].

Freeman SR. Diverticulitis. In: McNally PR, ed. GI/Liver Secrets. Philadelphia, Pa: Hanley & Belfus; 1996:332-338.

www.medscape.com/viewarticle/819310. Accessed January 20, 2014.

Isselbacher KJ, Epstein A. Diverticular disease. In: Braunwald E, Longo DL, et al, eds. Harrison's Principles of Internal Medicine. 14 th ed. McGraw-Hill; 1998:1648-1649.

Jacobs DO. Clinical practice. Diverticulitis. N Engl J Med. Nov 15 2007;357(20):2057-66. [Medline].

Janes SE, Meagher A, Frizelle FA. Management of diverticulitis. BMJ. Feb 4 2006;332(7536):271-5. [Medline].

emedicine.medscape.com/article/774922-overview.

Kornitzer BS, Manace LC, Fischberg DJ, Leipzig RM. Prevalence of meperidine use in older surgical patients. Arch Surg. Jan 2006;141(1):76-81. [Medline].

Marinella MA, Mustafa M. Acute diverticulitis in patients 40 years of age and younger. Am J Emerg Med. Mar 2000;18(2):140-2. [Medline].

McCarthy DW, Bumpers HL, Hoover EL. Etiology of diverticular disease with classic illustrations. J Natl Med Assoc. Jun 1996;88(6):389-90. [Medline]. [Full Text].

Miura S, Kodaira S, Shatari T, Nishioka M, Hosoda Y, Hisa TK. Recent trends in diverticulosis of the right colon in Japan: retrospective review in a regional hospital. Dis Colon Rectum. Oct 2000;43(10):1383-9. [Medline].

Mueller MH, Glatzle J, Kasparek MS, Becker HD, Jehle EC, Zittel TT, et al. Long-term outcome of conservative treatment in patients with diverticulitis of the sigmoid colon. Eur J Gastroenterol Hepatol. Jun 2005;17(6):649-54. [Medline].

Novak JS, Tobias J, Barkin JS. Nonsurgical management of acute jejunal diverticulitis: a review. Am J Gastroenterol. Oct 1997;92(10):1929-31. [Medline].

Oliver G, Lowry A, Vernava A, Hicks T, Burnstein M, Denstman F, et al. Practice parameters for antibiotic prophylaxis--supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons. Dis Colon Rectum. Sep 2000;43(9):1194-200. [Medline]. [Full Text].

Parks TG. Natural history of diverticular disease of the colon. Clin Gastroenterol. Jan 1975;4(1):53-69. [Medline].

Patel DG, Thomson WG. Diverticulitis and diverticular hemorrhage. In: Clinical Practice of Gastroenterology. Philadelphia, Pa: Churchill Livingstone; 1999:727-732.

Pemberton JH, Armstrong DN, Dietzen CD. Diverticulitis. In: Yamada T, Alpers DH, et al, eds. Textbook of Gastroenterology. Philadelphia, Pa: Lippincott Williams & Wilkins; 1995:1876-1888.

Poletti PA, Platon A, Rutschmann O, Kinkel K, Nyikus V, Ghiorghiu S, et al. Acute left colonic diverticulitis: can CT findings be used to predict recurrence. AJR Am J Roentgenol. May 2004;182(5):1159-65. [Medline].

Rafferty J, Shellito P, Hyman NH, Buie WD. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. Jul 2006;49(7):939-44. [Medline].

Rampton DS. Diverticular colitis: diagnosis and management. Colorectal Dis. May 2001;3(3):149-53. [Medline].

Rao PM, Rhea JT, Novelline RA, Dobbins JM, Lawrason JN, Sacknoff R, et al. Helical CT with only colonic contrast material for diagnosing diverticulitis: prospective evaluation of 150 patients. AJR Am J Roentgenol. Jun 1998;170(6):1445-9. [Medline].

Rege RV, Nahrwold DL. Diverticular disease. Curr Probl Surg. Mar 1989;26(3):133-89. [Medline].

Regenbogen SE, Hardiman KM, Hendren S, Morris AM. Surgery for Diverticulitis in the 21st Century: A Systematic Review. JAMA Surg. Jan 15 2014;[Medline].

Ripolles T, Agramunt M, Martinez MJ, Costa S, Gomez-Abril SA, Richart J. The role of ultrasound in the diagnosis, management and evolutive prognosis of acute left-sided colonic diverticulitis: a review of 208 patients. Eur Radiol. Dec 2003;13(12):2587-95. [Medline].

Schoetz DJ Jr. Uncomplicated diverticulitis. Indications for surgery and surgical management. Surg Clin North Am. Oct 1993;73(5):965-74. [Medline].

Schreyer AG, Furst A, Agha A, Kikinis R, Scheibl K, Scholmerich J, et al. Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis. Sep 2004;19(5):474-80. [Medline].

Silverman ME, Shih RD, Allegra J. Morphine induces less nausea than meperidine when administered parenterally. J Emerg Med. Oct 2004;27(3):241-3. [Medline].

Wu JS, Baker ME. Recognizing and managing acute diverticulitis for the internist. Cleve Clin J Med. Jul 2005;72(7):620-7. [Medline].

Yacoe ME, Jeffrey RB Jr. Sonography of appendicitis and diverticulitis. Radiol Clin North Am. Sep 1994;32(5):899-912. [Medline].

Young-Fadok T, Pemberton JH. Clinical manifestations, diagnosis, and treatment of acute diverticulitis. 2000.

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