Conservative Treatment of Acute Colonic Diverticulitis.

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.

journal_name

Curr Infect Dis Rep

authors

van Dijk ST,Rottier SJ,van Geloven AAW,Boermeester MA

doi

10.1007/s11908-017-0600-y

subject

Has Abstract

pub_date

2017-09-23 00:00:00

pages

44

issue

11

eissn

1523-3847

issn

1534-3146

pii

10.1007/s11908-017-0600-y

journal_volume

19

pub_type

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