Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec 13;37(6):359-367.
doi: 10.1055/s-0043-1777439. eCollection 2024 Nov.

Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence

Sonia Wu  1 , Maher Al Khaldi  1 , Carole S Richard  1 , François Dagbert  1
Affiliations
Review

Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence

Sonia Wu et al. Clin Colon Rectal Surg. .

Abstract

Acute diverticulitis represents a common colorectal emergency seen in the Western world. Over time, management of this condition has evolved. This review aims to highlight recent evidence and update current recommendations. Notable evidence has emerged in certain aspects of diverticulitis. This includes disease pathogenesis, as emerging data suggest a potentially greater role for the microbiome and genetic predisposition than previously thought. Acute management has also seen major shifts, where traditional antibiotic treatment may no longer be necessary for acute uncomplicated diverticulitis. Following successful medical management of acute diverticulitis, indications for elective sigmoidectomy have decreased. The benefit of emergency surgery remains for peritonitis, sepsis, obstruction, and acute diverticulitis in certain immunocompromised patients. Routine colonoscopy, once recommended after all acute diverticulitis episodes, has been shown to be beneficial for cancer exclusion in a distinct patient population. Despite advances in research, certain entities remain poorly understood, such as smoldering diverticulitis and symptomatic uncomplicated diverticular disease. As research in the field expands, paradigm shifts will shape our understanding of diverticulitis, influencing how clinicians approach management and educate patients.

Keywords: acute care surgery; colorectal surgery; diverticular disease; diverticulitis.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Approach to uncomplicated diverticulitis.
Fig. 2
Fig. 2
Approach to complicated diverticulitis.
See this image and copyright information in PMC

References

    1. Peery A F, Crockett S D, Murphy C C et al.Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018. Gastroenterology. 2019;156(01):254–272. - PMC - PubMed
    1. Tursi A, Scarpignato C, Strate L L et al.Colonic diverticular disease. Nat Rev Dis Primers. 2020;6(01):20. - PMC - PubMed
    1. Peery A F, Sandler R S, Ahnen D J et al.Constipation and a low-fiber diet are not associated with diverticulosis. Clin Gastroenterol Hepatol. 2013;11(12):1622–1627. - PMC - PubMed
    1. Strate L L, Liu Y L, Syngal S, Aldoori W H, Giovannucci E L. Nut, corn, and popcorn consumption and the incidence of diverticular disease. JAMA. 2008;300(08):907–914. - PMC - PubMed
    1. Maguire L H, Handelman S K, Du X, Chen Y, Pers T H, Speliotes E K. Genome-wide association analyses identify 39 new susceptibility loci for diverticular disease. Nat Genet. 2018;50(10):1359–1365. - PMC - PubMed