Management of Acute Diverticulitis
Based on guidelines from the American Gastroenterological Association.
These guideline summaries are shared for educational purposes only and are not intended to direct patient care. For detail on the specific recommendations and information about the evidence considered by the guideline developer, we encourage you to go to the original guideline statement cited below.
Diagnosis
The AGA suggests that colonoscopy be performed after resolution of acute diverticulitis in appropriate candidates to exclude the misdiagnosis of a colonic neoplasm if a high-quality examination of the colon has not been recently performed.
Treatment
The AGA suggests against elective colonic resection in patients with an initial episode of acute uncomplicated diverticulitis. The decision to perform elective prophylactic colonic resection in this setting should be individualized.
The AGA suggests that antibiotics should be used selectively, rather than routinely, in patients with acute uncomplicated diverticulitis.
The AGA suggests a fiber-rich diet or fiber supplementation in patients with a history of acute diverticulitis.
The AGA suggests against routinely advising patients with a history of diverticulitis to avoid consumption of seeds, nuts, and popcorn.
The AGA suggests advising patients with diverticular disease to consider vigorous physical activity.
The AGA suggests against routinely advising patients with a history of diverticulitis to avoid the use of aspirin.
The AGA suggests advising patients with a history of diverticulitis to avoid the use of nonaspirin NSAIDs if possible.
Prevention
The AGA recommends against the use of mesalamine after acute uncomplicated diverticulitis.
The AGA suggests against the use of rifaximin after acute uncomplicated diverticulitis.
The AGA suggests against the use of probiotics after acute uncomplicated diverticulitis.