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World J Gastroenterol. May 28, 2006; 12(20): 3225-3228
Published online May 28, 2006. doi: 10.3748/wjg.v12.i20.3225
Management of diverticular disease is changing
Martin H Floch, Jonathan A White
Martin H Floch, Digestive Disease Section, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, PO Box 208019, New Haven, CT 06520, United States
Jonathan A White, Section of Gastroenterology, Norwalk Hospital, 24 Stevens Street, Norwalk, CT 06856, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Martin H Floch, MD, Digestive Disease Section, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, PO Box 208019, New Haven, CT 06520, United States. martin.floch@yale.edu
Telephone: +1-203-7376061 Fax: +1-203-7371755
Received: March 29, 2006
Revised: April 6, 2006
Accepted: April 16, 2006
Published online: May 28, 2006
Abstract

Diverticular disease of the colon is primarily a disease of humans living in westernized and industrialized countries. Sixty percent of humans living in industrialized countries will develop colonic diverticula. It is rare before the age of 40, but more prone to complications when it occurs in the young. By age 80, over 65% of humans have colonic diverticula. The cause remains uncertain, but epidemiologic studies attribute it to dietary fiber deficiency. The cause of diverticulitis remains uncertain, but new observations and hypotheses suggest that it is due to chronic inflammation in the bowel wall. Standard medical therapies of bowel rest and antibiotics are still the recommended treatment. However, changing concepts and new therapies indicate that anti-inflammatory agents such as mesalamine and possibly probiotics may be helpful in shortening the course and perhaps preventing recurrences. Standard surgical treatment for perforation for severe acute disease has developed so that two-stage procedures are recommended. In addition, laparoscopic surgery has proven safe and may slowly become the technique of choice.

Keywords: Diverticulitis; Mesalamine; Treatments