Review article: the pathogenesis and management of acute colonic diverticulitis

Humes, David J.; Spiller, Robin C.

doi:10.1111/apt.12596

Cited by 71 publications

(63 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is no clear evidence on the effect of different drug treatments like antibiotics, probiotics or 5-aminosalicylates in preventing recurrent attacks of acute diverticulitis [14].…”

Section: Follow-up In Primary Carementioning

confidence: 99%

Diverticular Disease in the Primary Care Setting

Wensaas

Hungin

2016

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

Diverticular disease is a chronic and common condition, and yet the impact of diverticular disease in primary care is largely unknown.The diagnosis of diverticular disease relies on the demonstration of diverticula in the colon, and the necessary investigations are often not available in primary care. The specificity and sensitivity of symptoms, clinical signs and laboratory tests alone are generally low and consequently the diagnostic process will be characterized by uncertainty. Also, the criteria for symptomatic uncomplicated diverticular disease in the absence of macroscopic inflammation are not clearly defined. Therefore both the prevalence of diverticular disease and the incidence of diverticulitis in primary care are unknown.Current recommendations for treatment and follow-up of patients with acute diverticulitis are based on studies where the diagnosis has been verified by computerized tomography. The results cannot be directly transferred to primary care where the diagnosis has to rely on the interpretation of symptoms and signs. Therefore, one must allow for greater diagnostic uncertainty, and safety netting in the event of unexpected development of the condition is an important aspect of the management of diverticulitis in primary care.The highest prevalence of diverticular disease is found among older patients, where multimorbidity and polypharmacy is common. The challenge is to remember the possible contribution of diverticular disease to the patient's overall condition and to foresee its implications in terms of advice and treatment in relation to other diseases.

show abstract

“…There is no clear evidence on the effect of different drug treatments like antibiotics, probiotics or 5-aminosalicylates in preventing recurrent attacks of acute diverticulitis [14].…”

Section: Follow-up In Primary Carementioning

confidence: 99%

Diverticular Disease in the Primary Care Setting

Wensaas

Hungin

2016

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

show abstract

“…Among individuals in Olmstead County, the incidence of diverticulitis increased by 50% between 1990–1999 and 2000–2007, with a particularly notable rise in younger individuals [8]. The development of acute diverticulitis is associated with obesity, smoking, diet, lack of physical activity, and the use of nonsteroidal anti-inflammatory drugs [9]. Younger individuals with diverticulitis tend to have similar or less severe disease, though they tend to be re-admitted more frequently [8,10,11].…”

Section: Introductionmentioning

confidence: 99%

Emergency Department Burden of Diverticulitis in the USA, 2006–2013

et al. 2017

View full text Add to dashboard Cite

Goals The aim of this study was to analyze recent trends in ED visits for diverticulitis between 2006 and 2013. Background Acute diverticulitis is a serious medical condition that frequently leads to emergency department (ED) visits, hospitalizations, and surgeries resulting in a significant health care burden. Methods Data were obtained from the National Emergency Department Sample (NEDS) records in which diverticulitis (ICD-9-CM codes 562.11 and 562.13) was the primary diagnosis in the ED between 2006 and 2013. The NEDS collects data from more than 25 million visits in over 950 hospital emergency departments and is weighted to provide national estimates. Our findings reflected patient and hospital characteristics such as demographics, geographical region, and total charges for ED and inpatient stays. Results Between 2006 and 2013, the rate of diverticulitis-related ED visits increased by 26.8% from 89.8 to 113.9 visits per 100,000 population. The aggregate national cost of diverticulitis-related ED visits increased by 105%, from approximately $822 million in 2006 to over $1.6 billion in 2013. Cost data were adjusted for inflation and reported in 2015 dollars. The percentage of individuals admitted to the same hospital from the ED decreased from 58.0% to 47.1% from 2006 to 2013 respectively while the rate of bowel surgeries per 100,000 ED visits for diverticulitis decreased 33.7% from 2006 to 2013. Conclusions The number of ED visits due to diverticulitis and associated costs continued to rise between 2006 and 2013, while the rate of bowel surgeries and inpatient admissions through the ED for diverticulitis decreased.

show abstract

“…Diverticula develop where the colon wall is weak (1), the negative outcomes of which are bleeding and acute diverticulitis (2,3). Bleeding from diverticula accounts for 20-50% of lower gastrointestinal bleeding cases (4); this is usually self-limiting, but is occasionally fatal for patients taking non-steroidal anti-inflammatory drugs and anticoagulants (5-7).…”

Section: Introductionmentioning

confidence: 99%

Association between colon diverticula and hemoglobin, triglyceride and uric acid levels

Tomizawa

Shinozaki

Hasegawa

et al. 2015

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. Colon diverticula cause bleeding and acute diverticulitis. The present study analyzed laboratory test variables, aiming to predict the presence of diverticula. Patient records from between April 2011 and March 2014 were analyzed retrospectively (1,520 patients) and a one-way analysis of variance was performed to analyze the association between the presence of diverticula and each variable. A χ 2 test was then used to assess the correlation between the prevalence of diverticula and the percentage of patients with uric acid (UA) levels ≥5.1 mg/dl. A receiver operating characteristic (ROC) analysis was performed to determine the threshold values required to predict the presence of diverticula. Hemoglobin (Hb) levels were lower in patients with diverticula than in those without diverticula (P=0.0027), and compared with patients without diverticula, UA and triglyceride (TG) levels were higher in patients with diverticula (P=0.0066 and P=0.0136, respectively). The patients were divided into two groups, as follows: Patients with UA levels ≥5.1 mg/dl (the median value) and those with UA levels <5.1 mg/dl. The prevalence of diverticula was significantly higher in patients with UA levels ≥5.1 mg/dl than in those with UA levels <5.1 mg/dl (P=0.0004). ROC analysis demonstrated that the threshold values of Hb, TG and UA were 12,400, 146 and 5.1 mg/dl, respectively. The sensitivity of the Hb and UA levels at the threshold values was 76.5 and 71.0%, respectively. The prevalence of diverticula was associated with low Hb levels, and high TG and UA levels.

show abstract

Review article: the pathogenesis and management of acute colonic diverticulitis

Cited by 71 publications

References 79 publications

Diverticular Disease in the Primary Care Setting

Diverticular Disease in the Primary Care Setting

Emergency Department Burden of Diverticulitis in the USA, 2006–2013

Association between colon diverticula and hemoglobin, triglyceride and uric acid levels

Contact Info

Product

Resources

About