Review article: uncomplicated diverticular disease of the colon
Article first published online: 28 APR 2006
Alimentary Pharmacology & Therapeutics
Volume 23, Issue 10, pages 1379–1391, May 2006
How to Cite
PETRUZZIELLO, L., IACOPINI, F., BULAJIC, M., SHAH, S. and COSTAMAGNA, G. (2006), Review article: uncomplicated diverticular disease of the colon. Alimentary Pharmacology & Therapeutics, 23: 1379–1391. doi: 10.1111/j.1365-2036.2006.02896.x
- Issue published online: 28 APR 2006
- Article first published online: 28 APR 2006
- Publication data Submitted 21 November 2005 First decision 27 November 2005 Resubmitted 17 February 2006 Accepted 22 February 2006
Diverticular disease of the colon is the fifth most important gastrointestinal disease in terms of direct and indirect healthcare costs in western countries. Uncomplicated diverticular disease is defined as the presence of diverticula in the absence of complications such as perforation, fistula, obstruction and/or bleeding. The distribution of diverticula along the colon varies worldwide being almost always left-sided and directly related to age in western countries and right-sided where diet is rich in fibre.
The pathophysiology of diverticular disease is complex and relates to abnormal colonic motility, changes in the colonic wall, chronic mucosal low-grade inflammation, imbalance in colonic microflora and visceral hypersensitivity. Moreover, there can be genetic factors involved in the development of colonic diverticula.
The use of non-absorbable antibiotics is the mainstay of therapy in patients with mild to moderate symptoms, and the effect of fibre-supplementation alone does not appear to be significantly different from placebo, although no definite data are available.
More recently, alternative treatments have been reported. Mesalazine acts as a local mucosal immunomodulator and has been shown to improve symptoms and prevent recurrence of diverticulitis. In addition, probiotics have also been shown to be beneficial by re-establishing a normal gut microflora. In this study, the current literature on uncomplicated diverticular disease of the colon is reviewed.