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2018 ; 12
(2
): 125-132
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Diverticular Disease: An Update on Pathogenesis and Management
#MMPMID28494576
Rezapour M
; Ali S
; Stollman N
Gut Liver
2018[Mar]; 12
(2
): 125-132
PMID28494576
show ga
Diverticular disease is one of the most common conditions in the Western world
and one of the most common findings identified at colonoscopy. Recently, there
has been a significant paradigm shift in our understanding of diverticular
disease and its management. The pathogenesis of diverticular disease is thought
to be multifactorial and include both environmental and genetic factors in
addition to the historically accepted etiology of dietary fiber deficiency.
Symptomatic uncomplicated diverticular disease (SUDD) is currently considered a
type of chronic diverticulosis that is perhaps akin to irritable bowel syndrome.
Mesalamine, rifaximin and probiotics may achieve symptomatic relief in some
patients with SUDD, although their role(s) in preventing complications remain
unclear. Antibiotic use for acute diverticulitis and elective prophylactic
resection surgery are considered more individualized treatment modalities that
take into account the clinical status, comorbidities and lifestyle of the
patient. Our understanding of the pathogenesis of diverticular disease continues
to evolve and is likely to be diverse and multifactorial. Paradigm shifts in
several areas of the pathogenesis and management of diverticular disease are
explored in this review.