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Diverticular colitis: diagnosis and management.

D S Rampton1

  • 1Department of Adult and Paediatric Gastroenterology, St Bartholomew's & Royal London School of Medicine & Dentistry, London, UK. drampton@mds.qmw.ac.uk

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|June 7, 2003
PubMed
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Diverticular colitis, a sigmoid inflammation linked to diverticulosis, often causes rectal bleeding. Most patients improve with diet and medication, but some need surgery.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Diverticular colitis is a distinct sigmoid colitis associated with diverticulosis.
  • It presents with rectal bleeding and mimics other colitis types.

Purpose of the Study:

  • To review the literature on diverticular colitis.
  • To propose an optimal management algorithm for this condition.

Main Methods:

  • Literature review of diverticular colitis.
  • Analysis of clinical, endoscopic, and pathological features.
  • Development of a management algorithm.

Main Results:

  • Diverticular colitis requires differentiation from ulcerative colitis, Crohn's disease, ischemic colitis, and NSAID-induced colitis.

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  • Most patients respond to conservative treatment (high-fiber diet, antibiotics, aminosalicylates).
  • A minority of patients with persistent symptoms require sigmoid resection.

    • Conclusions:

    • Diverticular colitis is a recognized entity requiring careful diagnosis.
    • Conservative management is effective for most patients.
    • Surgical intervention is reserved for refractory cases.