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Feature Article

Diverticular disease: picking the facts out of the pockets

Vi Nguyen, Christopher S Pokorny

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Abstract

Diverticulosis is common and mostly asymptomatic. However, it can be complicated by inflammation, haemorrhage, fistulas and perforation. Colonoscopy is an important tool for investigation and diagnosis.

Key Points

  • The incidence of diverticulosis increases with age, although the cause remains unclear.
  • Diverticula are the most common finding in all patients at routine colonoscopy.
  • In most cases, diverticulosis is asymptomatic. Complications of diverticular disease include diverticulitis, bleeding, abscesses, fistulas, strictures and diverticular colitis.
  • There is no evidence that avoiding nuts, corn and seeds can prevent complications of diverticulosis.
  • Fibre appears to be important in the prevention of diverticulitis episodes, but its role in preventing the development of diverticula is not clear.
  • Although their use is contentious, antibiotics are still the mainstay of treatment for mild, uncomplicated cases of acute diverticulitis.
  • There may be a role for anti-inflammatories and probiotics in the future management of patients with diverticulitis.

    Picture credit: © Science Photo Library/Du Cane Medical Imaging Ltd/Diomedia.com

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