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Diverticular Disease

Andrew Harner, MD, Brianna Stadsvold, MD and Aaron Bolduc, MD Reviewed 06/2020
 


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% 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 (see exce...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

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

  • Colonoscopy should be perf...

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.
2
Feingold D, St...

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.

  • Katz LH, Guy DD, Lahat A...

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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