Editorial
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2020; 12(2): 53-59
Published online Feb 16, 2020. doi: 10.4253/wjge.v12.i2.53
Colonoscopic management of diverticular disease
M Phillip Fejleh, James H Tabibian
M Phillip Fejleh, UCLA Gastroenterology Fellowship Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
James H Tabibian, Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States
Author contributions: Fejleh MP drafted the manuscript; Tabibian JH acquired and selected the figures, provided supervision and critical revision of the manuscript.
Conflict-of-interest statement: No potential conflicts of interest, no financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: M Phillip Fejleh, MD, Gastroenterology Fellow, UCLA Gastroenterology Fellowship Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 10945 Le Conte Ave, PVUB 2114, MC 694907, Los Angeles, CA 90095, United States. mfejleh@mednet.ucla.edu
Received: October 15, 2019
Peer-review started: October 15, 2019
First decision: November 21, 2019
Revised: December 18, 2019
Accepted: December 23, 2019
Article in press: December 23, 2019
Published online: February 16, 2020
Abstract

Diverticula are the most common incidental finding during routine colonoscopy, and their prevalence increases with patient age. The term “diverticular disease” encompasses the range of clinical manifestations and complications that can occur with colonic diverticula, including diverticular bleeding, diverticulitis-associated strictures, and acute diverticulitis. Colonoscopy is a vital tool in the diagnosis and management of diverticular disease and can be useful in a variety of regards. In this editorial, we concisely delineate the current approach to and practices in colonoscopic management of diverticular disease. In particular, we discuss treatment options for diverticular bleeding, propose consideration of colonic stenting as a bridge to surgery in patients with diverticulitis-associated strictures, and the need for diagnostic colonoscopy following an episode of acute diverticulitis in order to rule out underlying conditions such as colonic malignancy or inflammatory bowel disease. In addition, we offer practical tips for performing safe and successful colonoscopy in patients with dense diverticulosis coli.

Keywords: Acute diverticulitis, Diverticular bleeding, Colon stricture

Core tip: Diverticular disease, which encompasses the range of clinical manifestations and complications that can occur with colonic diverticula, is frequently encountered in clinical practice. Colonoscopy is a vital tool in the diagnosis and management of diverticular disease. In this editorial, we delineate current and evolving practices in colonoscopic management of diverticular disease, including diverticular bleeding, diverticulitis-associated strictures, and provide practical tips for successful completion of colonoscopy in patients with dense diverticulosis coli.