Janes S, Meagher A, Frizelle FA. Elective surgery after acute diverticulitis

Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
British Journal of Surgery (Impact Factor: 5.21). 02/2005; 92(2):133-42. DOI: 10.1002/bjs.4873
Source: PubMed

ABSTRACT Diverticulitis is a common condition. Practice guidelines from many organizations recommend bowel resection after two attacks. The evidence for such a recommendation is reviewed.
A Medline literature search was performed to locate English language articles on surgery for diverticular disease. Further articles were obtained from the references cited in the literature initially reviewed.
Most people with diverticulosis are asymptomatic. Diverticular disease occurs in over 25 per cent of the population, increasing with age. After one episode of diverticulitis one-third of patients have recurrent symptoms; after a second episode a further third have a subsequent episode. Perforation is commonest during the first episode of acute diverticulitis. After recovering from an episode of diverticulitis the risk of an individual requiring an urgent Hartmann's procedure is one in 2000 patient-years of follow-up. Surgery for diverticular disease has a high complication rate and 25 per cent of patients have ongoing symptoms after bowel resection.
There is no evidence to support the idea that elective surgery should follow two attacks of diverticulitis. Further prospective trials are required.

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Available from: Frank Antony Frizelle, Aug 25, 2015
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    • "Acute diverticulitis is characterized by inflammation , microperforation and abscess formation; 25–33% of these patients may have recurrent episodes [Haglund et al. 1979; Janes et al. 2005]. In patients with gastrointestinal symptoms without overt diverticulitis, low grade inflammation, gut dysbiosis, visceral hypersensitivity and colonic dysmotility have been identified as potential contributing factors to symptoms [Floch, 2006]. "
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    ABSTRACT: Diverticulosis is one of the most common gastrointestinal conditions affecting the general population in the Western world. It is estimated that over 2.5 million people are affected by diverticular disease in the United States. The spectrum of clinical manifestations of diverticulosis ranges from asymptomatic diverticulosis to complicated diverticulitis. Treatment for symptomatic diverticular disease is largely based on symptoms. Traditional therapy includes fiber, bowel rest, antibiotics, pain control and surgery for selected cases. This review discusses recent advances in the medical treatment of diverticular disease such as the use of mesalamine, rifaximin and probiotics as our understanding of the disease evolves.
    Therapeutic Advances in Gastroenterology 05/2013; 6(3):205-13. DOI:10.1177/1756283X13478679
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    ABSTRACT: ABSTRACT Objective: The aims of this thesis were to evaluate the influence of ethnicity and other socio- demographic factors on the rate of diverticular disease (DD) (Paper I), to compare findings specific for DD and ,acceptance of CT Colonography (CTC) and conventional Colonoscopy (CC) in patients examined after diverticulitis (AD) (Paper II), to evaluate the value of antibiotics inconservative,treatment of patients ,with mild AD (Paper III) and to study ,patients with diverticular fistulas to the female genital tract (Paper IV). Methods: In paper I, Swedish national registers with information about health and socio- demographic,indicators were used to study ethnicity and other socio-demographic factors and
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