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Table of Contents
Vol. 73, Suppl. 1, 2006
Issue release date: February 2006
Section title: Paper
Digestion 2006;73:58–66
(DOI:10.1159/000089780)

Management of Colonic Diverticular Disease

Frieri G. · Pimpo M.T. · Scarpignato C.
aGastroenterology Unit, School of Medicine and Dentistry, University of L’Aquila, L’Aquila, and bLaboratory of Clinical Pharmacology, Department of Anatomy, Pharmacology and Forensic Sciences, University of Parma, Parma, Italy

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 2/27/2006

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG

Abstract

Diverticular disease of the colon is a complex syndrome that includes several clinical conditions, each needing different therapeutic strategies. In patients with asymptomatic diverticulosis, only a fiber-rich diet can be recommended in an attempt to reduce intraluminal pressure and slow down the worsening of the disease. Fiber supplementation is also indicated in symptomatic diverticulosis in order to get symptom relief and prevent acute diverticulitis. In this regard, the best results have been obtained by combination of soluble fiber, like glucomannan, and poorly absorbed antibiotics, like rifaximin, given 7–10 days every month. For uncomplicated diverticulitis the standard therapy is liquid diet and oral antimicrobials, usually ciprofloxacin and metronidazole. Hospitalization, bowel rest, and intravenous antibacterial agents are mandatory for complicated diverticulitis. Haemorrhage is usually a self-limited event but may require endoscopic or surgical treatment. Once in remission, continuous fiber intake and intermittent course of rifaximin may improve symptoms and reduce diverticulitis recurrence. These preventive strategies will likely improve patients’ quality of life and reduce management costs. A surgical approach in diverticular disease is needed in 15–30% of cases and consists of removing the intestinal segment affected by diverticula. It is indicated in diffuse peritonitis, abscesses, fistulas, stenosis and after the second to fourth attack of uncomplicated diverticulitis. Young people and immunocompromised patients are more likely to be operated.


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 2/27/2006

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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