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Diverticular Disease

Andrew Harner, MD, Brian P. Bateson, DO and Steven B. Holsten, Jr., MD Reviewed 06/2019
 


BASICS

DESCRIPTION

Diverticulum (single) or diverticula (multiple) are outpouchings in the colonic wall. Diverticular disease is a spectrum of diseases impacting the entire GI tract (except the rectum)...

DIAGNOSIS

HISTORY

  • Diverticulosis

    • 80–85% of patients are asymptomatic. Of the 15–20% with symptoms, 1–2% will require hospitalization, and 0.5% will undergo surgery.

    • The most common symptom is dull, colic...

TREATMENT

GENERAL MEASURES

  • Diverticulosis: outpatient therapy with fiber supplementation and/or bulking agents (psyllium) (>30 g/day) (2)[A]

  • Uncomplicated diverticulitis: outpatient therapy with or w...

ONGOING CARE

DIET

  • Bowel rest with NPO during acute diverticulitis; advance diet as tolerated as bowel function returns

  • Patients with known diverticulosis or a history of diverticulitis should consume a ...

REFERENCES

1
Strate LL, Modi R, Cohen E, et al. Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights. Am J Gastroenterol.  2012;107(10):1486–1493. [View Abstract...

ADDITIONAL READING

  • Boynton W, Floch M. New strategies for the management of diverticular disease: insights for the clinician. Therap Adv Gastroenterol.  2013;6(3):205–213. [View Abstract on OvidM...

CODES

ICD10

  • K57.90 Dvrtclos of intest, part unsp, w/o perf or abscess w/o bleed

  • K57.30 Dvrtclos of lg int w/o perforation or abscess w/o bleeding

  • K57.92 Diverticulitis of intestine, part unspecified, wit...

CLINICAL PEARLS

  • Diverticulosis is common in elderly patients with a sedentary lifestyle who consume a Western diet.

  • Patients with diverticulosis benefit from a high-fiber diet.

  • Acute uncomplicated diver...

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