Acute Uncomplicated Diverticulitis: What to Do Until We Have Better Data
Authors: Robert M. Centor
Journal: Annals of Internal Medicine (2015)

Ideas and Opinions19 November 2015Acute Uncomplicated Diverticulitis: What to Do Until We Have Better DataRobert M. Centor, MDRobert M. Centor, MDFrom the University of Alabama School of Medicine Huntsville Regional Medical Campus, Huntsville, Alabama.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2499 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Acute uncomplicated diverticulitis occurs in approximately 4% of patients with diverticulosis. Outpatient, acute care, and inpatient physicians all participate in their care. The American Gastroenterological Association (AGA) has developed a new guideline on this subject (updating a previous guideline from 1999) (1).Before considering these guidelines, we must clearly define acute uncomplicated diverticulitis. The definition requires a computed tomography scan that documents the lack of abscesses or fistulas. Patients with clinical findings of severe infection or sepsis have complicated diverticulitis. Patients with risk factors for more severe disease, such as immunosuppression, or significant comorbidities do not fit the definition. This ...References1. Stollman N, Smalley W, Hirano I; AGA Institute Clinical Guidelines Committee. American Gastroenterological Association Institute Guideline on the Management of Acute Diverticulitis. Gastroenterology. 2015. [PMID: 26453777] CrossrefMedlineGoogle Scholar2. Isacson D, Thorisson A, Andreasson K, Nikberg M, Smedh K, Chabok A. Outpatient, non-antibiotic management in acute uncomplicated diverticulitis: a prospective study. Int J Colorectal Dis. 2015;30:1229-34. [PMID: 25989930] CrossrefMedlineGoogle Scholar3. Chabok A, Påhlman L, Hjern F, Haapaniemi S, Smedh K; AVOD Study Group. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012;99:532-9. [PMID: 22290281] doi:10.1002/bjs.8688 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert M. Centor, MDAffiliations: From the University of Alabama School of Medicine Huntsville Regional Medical Campus, Huntsville, Alabama.Disclosures: The author has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2499.Corresponding Author: Robert M. Centor, MD, Regional Dean, UAB Huntsville Regional Medical Campus, 301 Governors Drive, Huntsville, AL 35801; e-mail, rcentor@uab.edu.Author Contributions: Conception and design: R.M. Centor.Drafting of the article: R.M. Centor.Final approval of the article: R.M. Centor.Administrative, technical, or logistic support: R.M. Centor.This article was published at www.annals.org on 19 November 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRandomised clinical trial: mesalazine versus placebo in the prevention of diverticulitis recurrenceAcute colonic diverticulitis: modern understanding of pathomechanisms, risk factors, disease burden and severityGastroenterology 2011–2016: Looking Back and Forward 19 January 2016Volume 164, Issue 2Page: 120-121KeywordsAntibioticsColonoscopyDiverticulitisInpatientsMedical risk factorsNSAIDsOutpatientsProbioticsSurgeryTreatment guidelines ePublished: 19 November 2015 Issue Published: 19 January 2016 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...