Diverticular disease: paradigm shifts in pathogenesis and treatment

Colonic diverticulosis is one of the most common gastrointestinal conditions affecting the Western world and is recognized as an increasingly common condition since its first description in the 1800s. Despite its widespread prevalence, its exact pathogenesis remains unknown. Additionally, its wide spectrum of clinical manifestations has led to multiple approaches in the management of this disease. Our understanding of the condition has continued to evolve. Newer studies have challenged some long-held beliefs regarding diverticular disease (DD) and put forward some new theories. This has laid the groundwork for further research to be done in this area to improve our understanding of DD. In any individual case, diet therapy, rifaximin, mesalamine, antibiotics, or surgery may be useful depending on the clinical status.