Emerging therapies for diverticular disease of the colon

Abstract

Diverticular disease (DD) of the colon is common. This paper reviews the evidence supporting the role of some of the conventional medical therapies such as fiber and nonabsorbable antibiotics in the treatment of DD. More importantly, it will review the emerging body of evidence supporting the use of 5-aminosalicylic acid and probiotics for symptomatic or complicated DD. Possible mechanisms supporting the role of 5-aminosalicylates will also be discussed. On the basis of strength of the evidence supporting each medical intervention, recommendations will be graded in an evidence-based fashion. Finally, an evidence-based algorithmic approach is proposed for the medical management of DD. This paper does not discuss the use of absorbable antibiotics such as ciprofloxin and metronidazole, which are discussed in all standard textbooks. The purpose of this paper is to discuss newer recommendations.