Treatment of diverticulitis comprises at least two options: conservative or surgical management. There is a recent trend to limit surgical treatment of acute diverticulitis and to favor conservative management. This review addresses general aspects of conservative patient care with special focus on the treatment of patients with a first attack of diverticulitis. The presentation does not include a discussion of specific drugs which is given in other sections of this issue.

Keywords:
Diverticulitis, Conservative management, Diet, Antibiotics, Pain control
1.
Ripollés T, Agramunt M, Martinez MJ, et al: The role of ultrasound in the diagnosis, management and evolutive prognosis of acute left-sided colonic diverticulitis: a review of 208 patients. Eur Radiol 2003;13:2587–2595.
2.
Strate LL, Liu YL, Aldoori WH, et al: Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology 2009;136:115–122.
3.
Kotzampassakis N, Pittet O, Schmidt S, et al: Presentation and treatment outcome of diverticulitis in younger adults: a different disease than in older patients? Dis Colon Rectum 2010;53:333–338.
4.
Faria GR, Almeida AB, Moreira H, et al: Acute diverticulitis in younger patients: any rationale for a different approach? World J Gastroenterol 2011;17:207–212.
5.
Mizuki A, Nagata H, Tatemichi M, et al: The out-patient management of patients with acute mild-to-moderate colonic diverticulitis. Aliment Pharmacol Ther 2005;21:889–897.
6.
Martin GJ, Serralta De Colsa D, et al: Safety and efficiency of ambulatory treatment of acute diverticulitis. Gastroenterol Hepatol 2009;32:83–87.
7.
Arwidsson S Knock NG, Lehmann L, et al: Pathogenesis of multiple diverticula of the sigmoid colon in diverticular disease. Acta Chir Scand 1964;Suppl 342:1–68.
8.
Rao SS, Kavelock R, Beaty J, et al: Effects of fat and carbohydrate meals on colonic motor response. Gut 2000;46:205–211.
9.
Ridgway PF, Latif A, Shabbir J, et al: Randomized controlled trial of oral vs intravenous therapy for the clinically diagnosed acute uncomplicated diverticulitis. Colorectal Dis 2009;11:941–946.
10.
Brodribb AJ: Treatment of symptomatic diverticular disease with a high-fibre diet. Lancet 1977;i:664–666.
11.
Ornstein MH, Littlewood ER, Baird IM, et al: Are fibre supplements really neccessary in diverticular disease of the colon? A controlled clinical trial. BMJ 1981;282:1353–1356.
12.
Schechter S, et al: Management of uncomplicated acute diverticulitis: results of a survey. Dis Colon Rectum 1999;42:470–478.
13.
Hjern F, Josephson T, Altmann D, et al: Conservative treatment of acute colonic diverticulitis: are antibiotics always mandatory? Scand J Gastroenterol 2007;42:41–47.
14.
de Korte N, Kuyvenhoven JP, van der Peet DL, et al: Mild colonic diverticulitis can be treated without antibiotics. A case-controlled study. Colorectal Dis 2011, Epub ahead of print.
15.
Spiller RC: Pain in diverticular disease; in Kruis W, et al (eds): Diverticular Disease: Emerging Evidence in a Common Disease. Dordrecht, Springer, 2006, pp 111–119.
16.
Kruis W, Meier E, Mickisch O, et al: Treatment of painful diverticular disease of the colon with mesalamine. A placebo-controlled study. Gastroenterology 2007;132: A191–A191.
17.
Weinreich J: Treatment of diverticular disease. Scand J Gastroenterol 1982;79(suppl):128–129.
18.
Painter NS: Diverticular disease of the colon. BMJ 1968;3:475–479.
© 2012 S. Karger AG, Basel
2012
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