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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index


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REVIEW  DIVERTICULAR DISEASE: PITFALLS, CHALLENGES AND SOLUTIONS


Minerva Gastroenterologica e Dietologica 2017 June;63(2):130-42

DOI: 10.23736/S1121-421X.16.02357-6

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Rationale and evidences for treatment of symptomatic uncomplicated diverticular disease

Rosario CUOMO, Martina CARGIOLLI, Paolo ANDREOZZI, Francesco P., ZITO, Giovanni SARNELLI

Unit of Gastroenterology, Department of Clinical Medicine and Surgery, “Federico II” School of Medicine, Naples, Italy


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INTRODUCTION: Symptomatic uncomplicated diverticular disease (SUDD) is one of the possible clinical manifestations of diverticular disease. It is a common disorder characterized by chronic abdominal symptoms ranging from lower left abdominal pain to alteration of bowel habit, that significantly reduce quality of life of subject affected. The present article aims to review the current data for medical management of SUDD.
EVIDENCE ACQUISITION: We analyzed the existing literature on the factors involved in the pathogenesis of SUDD and we highlighted the possible target for treatment. Treatment for SUDD should be direct to relieve chronic symptoms and prevent diverticulitis and its complications. In particular we focused on the role of probiotics, fiber-diet, mesalazine and rifaximin on these two aspects. In this setting, we conducted a PubMed search for guidelines, systematic reviews and meta-analyses and updated information to October 2016.
EVIDENCE SYNTHESIS: Each topic was evaluated according to the best evidences available. Best results seemed to be obtained with combined therapies and in particular with rifaximin associated to high fiber-diet. This regimen seems to guarantee better symptoms control compared to fiber alone and it is more effective in preventing acute diverticulitis. On the contrary, no clear evidences about the efficacy of mesalazine and probiotics are available.
CONCLUSIONS: The results of the studies available in literature are controversial and debatable, for this reason a clear and defined algorithm for treatment of SUDD has not yet been defined. Further randomized, double-blind, placebo controlled study are necessary.


KEY WORDS: Diverticulum, colon - Abdominal pain - Irritable bowel syndrome - Dietary fiber - Probiotics

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Publication History

Issue published online: April 3, 2017
Article first published online: December 14, 2016

Cite this article as

Cuomo R, Cargiolli M, Andreozzi P, Zito FP, Sarnelli G. Rationale and evidences for treatment of symptomatic uncomplicated diverticular disease. Minerva Gastroenterol Dietol 2017;63:130-42. DOI: 10.23736/S1121-421X.16.02357-6

Corresponding author e-mail

rosario.cuomo@unina.it