A Tursi1, S Papagrigoriadis. 1. Digestive Endoscopy Unit, Lorenzo Bonomo Hospital, Andria, Italy. antotursi@tiscali.it
Abstract
BACKGROUND: Formation of colonic diverticula, via herniation of the colonic wall, is responsible for the development of diverticulosis and consequently diverticular disease. Diverticular disease can be associated with numerous debilitating abdominal and gastrointestinal symptoms (including pain, bloating, nausea, constipation and diarrhoea). AIMS: To review the state of treatment for diverticular disease and its complications, and briefly discuss potential future therapies. METHODS: PubMed and recent conference abstracts were searched for articles describing the treatment of diverticular disease. RESULTS: Many physicians will recommend alterations to lifestyle and increasing fibre consumption. Empirical antibiotics remain the mainstay of therapy for patients with diverticular disease and rifaximin seems to be the best choice. In severe or relapsing disease, surgical intervention is often the only remaining treatment option. Although novel treatment options are yet to become available, the addition of therapies based on mesalazine (mesalamine) and probiotics may enhance treatment efficacy. CONCLUSIONS: Data suggest that diverticular disease may share many of the hallmarks of other, better-characterized inflammatory bowel diseases; however, treatment options for patients with diverticular disease are scarce, revolving around antibiotic treatment and surgery. There is a need for a better understanding of the fundamental mechanisms of diverticular disease to design treatment regimens accordingly.
BACKGROUND: Formation of colonic diverticula, via herniation of the colonic wall, is responsible for the development of diverticulosis and consequently diverticular disease. Diverticular disease can be associated with numerous debilitating abdominal and gastrointestinal symptoms (including pain, bloating, nausea, constipation and diarrhoea). AIMS: To review the state of treatment for diverticular disease and its complications, and briefly discuss potential future therapies. METHODS: PubMed and recent conference abstracts were searched for articles describing the treatment of diverticular disease. RESULTS: Many physicians will recommend alterations to lifestyle and increasing fibre consumption. Empirical antibiotics remain the mainstay of therapy for patients with diverticular disease and rifaximin seems to be the best choice. In severe or relapsing disease, surgical intervention is often the only remaining treatment option. Although novel treatment options are yet to become available, the addition of therapies based on mesalazine (mesalamine) and probiotics may enhance treatment efficacy. CONCLUSIONS: Data suggest that diverticular disease may share many of the hallmarks of other, better-characterized inflammatory bowel diseases; however, treatment options for patients with diverticular disease are scarce, revolving around antibiotic treatment and surgery. There is a need for a better understanding of the fundamental mechanisms of diverticular disease to design treatment regimens accordingly.
Authors: Meghan B Skiba; Lindsay N Kohler; Tracy E Crane; Elizabeth T Jacobs; Aladdin H Shadyab; Ikuko Kato; Linda Snetselaar; Lihong Qi; Cynthia A Thomson Journal: Cancer Epidemiol Biomarkers Prev Date: 2019-08-27 Impact factor: 4.254
Authors: Antonio Tursi; Giovanni Brandimarte; Francesco Di Mario; Maria L Annunziata; Mauro Bafutto; Maria A Bianco; Raffaele Colucci; Rita Conigliaro; Silvio Danese; Rudi De Bastiani; Walter Elisei; Ricardo Escalante; Roberto Faggiani; Luciano Ferrini; Giacomo Forti; Giovanni Latella; Maria G Graziani; Enio C Oliveira; Alfredo Papa; Antonio Penna; Piero Portincasa; Kjetil Søreide; Antonio Spadaccini; Paolo Usai; Stefanos Bonovas; Carmelo Scarpignato; Marcello Picchio; Piera G Lecca; Costantino Zampaletta; Claudio Cassieri; Alberto Damiani; Kari F Desserud; Serafina Fiorella; Rosario Landi; Elisabetta Goni; Maria A Lai; Flavia Pigò; Gianluca Rotondano; Giuseppe Schiaccianoce Journal: United European Gastroenterol J Date: 2015-11-13 Impact factor: 4.623
Authors: Antonio Tursi; Walter Elisei; Gian Marco Giorgetti; Cosimo Damiano Inchingolo; Rosanna Nenna; Marcello Picchio; Giovanni Brandimarte Journal: Int J Colorectal Dis Date: 2011-08-13 Impact factor: 2.571
Authors: Brennan M R Spiegel; Mark W Reid; Roger Bolus; Cynthia B Whitman; Jennifer Talley; Stanley Dea; Kamyar Shahedi; Hetal Karsan; Chassidy Teal; Gil Y Melmed; Erica Cohen; Garth Fuller; Linnette Yen; Paul Hodgkins; M Haim Erder Journal: Qual Life Res Date: 2014-07-25 Impact factor: 4.147