Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence.

Area of Science:

• Colorectal surgery
• Gastroenterology
• Digestive disease research

Background:

• Acute diverticulitis is a frequent colorectal emergency in Western populations.
• Its management has undergone significant evolution over time.
• Understanding of disease pathogenesis is advancing.

Purpose of the Study:

• To review recent evidence on acute diverticulitis.
• To update current clinical recommendations for management.
• To highlight shifts in understanding disease pathogenesis and treatment.

Main Methods:

• Literature review of recent evidence.
• Analysis of emerging data on disease pathogenesis.
• Evaluation of current management strategies and outcomes.

Main Results:

• Emerging data suggest a greater role for microbiome and genetic predisposition.
• Antibiotic treatment may not be necessary for acute uncomplicated diverticulitis.
• Indications for elective sigmoidectomy have decreased post-medical management.

Conclusions:

• Management of acute diverticulitis is shifting, with reduced reliance on antibiotics and surgery for uncomplicated cases.
• The role of colonoscopy is refined for specific patient groups.
• Further research is needed for poorly understood entities like smoldering diverticulitis.