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Gastroenterology clinic

Managing patients with diverticulosis

Bruce Stewart

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Abstract

While asymptomatic diverticular disease requires no specific treatment, acute diverticulitis should be managed with bowel rest and antibiotics, plus further investigation if symptoms do not resolve within 48 hours. Emergency surgery is sometimes necessary.

Article Extract

Remember
  • Diverticulosis is a common condition in the Western world, affecting most people over 50 years of age. The vast majority of patients will have no significant clinical sequelae and the diagnosis may only be made incidentally during investigations for other colonic pathology.
  • The aetiology is presumed to relate to a refined diet with inadequate fibre intake leading to segmental colonic spasm, with high intraluminal pressure between constricted segments allowing mucosal herniation through the muscular wall of the bowel (Figure). The herniation usually occurs along the line of feeding vessels, which represent the site of maximal weakness, and there is usually associated muscle wall hypertrophy due to the heightened muscular activity.

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