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Diverticular Disease

Brianna Stadsvold, M.D. and Davis M O'Brien, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

Diverticulum (single) or diverticula (multiple) are outpouchings of 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% undergo surgery.

    • The most common symptom is dull, colicky ab...

TREATMENT

GENERAL MEASURES

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

  • Uncomplicated diverticulitis: outpatient therapy (see exc...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Follow-up outpatients 2-3 days after initiating antibiotic therapy and then weekly thereafter until symptom resolution.

    • Repeat im...

REFERENCES

1
Tursi A, Scarpignato, C, Strate LL, et al. Colonic diverticular disease. Nat Rev Dis Primers. 2020;6(1):20.
2
Eckmann JD, Shaukat A. Updates in the understanding and management of diverticul...

CODES

ICD10

  • K57.92 Diverticulitis of intestine, part unspecified, without perforation or abscess without bleeding

  • K57.13 Diverticulitis of small intestine without perforation or abscess with bleeding

  • K57...

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

  • Antibiotics may not be nec...

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