Colonic diverticular disease

Abstract

Queries are meant to draw your attention to edits, inconsistencies or issues that are unclear. If we just ask you to confirm edits are correct, a simple yes/ok between the brackets will do [Au: OK? Is this what you meant? Edits OK? yes]. If questions are asked, please rephrase/update the manuscript text when addressing queries, so that the message is conveyed to the reader (do NOT just type your answer to our query).] [Au: Throughout the manuscript, please use consistent terminology. For example, acute diverticulitis is diverticular disease and in several instances, they are mentioned separately. For clearer understanding, please use consistent terminology and define cleary what diverticular disease refers to. Similarly, there is a slight ambiguity between the terms diverticulosis and asymptomatic diverticulosis. My understanding is that diverticulosis is always asymptomatic. Please refer to them consistently if they are used to refer to the same condition. Is acute uncomplicated diverticulitis as in some instances, its refered to as uncomplicated acute diverticulitis? Please also use the abbreviation, AUD, if this terminology is widely accepted in the field. Just wanted to flag these here to make it easier for you to address.][Au: Important! As I am managing the references for this manuscript, it is essential that changes to references are noted to me in a comment rather than edited manually (as this will likely unlink the references and cause much confusion). If a reference needs to be added, include the full reference details (at a minimum, PMID or DOI are needed) and precise location to be cited. If a reference needs to be deleted, state which reference (author, year) and not just the reference number (as this will change with every change to the references).You can move text around, including the references associated with any given statement, but please don't edit the reference list at the end of the document.

A Very Rare Case of Colosalpingeal Fistula Secondary to Diverticulitis: An Overview of Development, Clinical Features and Management

“…Diverticular disease is becoming more common, affecting up to 71.4% of the population over 80 years [2]. Literature reports an increase from 49,000 cases of diverticular disease in 2000 to more than 70,000 in 2006, the complicated diseases almost doubled between 1990 and 2005 [3].…”

Role of Inflammation in Pathophysiology of Colonic Disease: An Update

“…Diverticula is a sac-like protrusion that can occur throughout the gastrointestinal tract (including the esophagus [3], the stomach [4], and the small bowel [5]), however, they are most frequently found in the colon [6,7]. DD includes a range of diseases with different manifestations involving the presence of diverticula such as (i) diverticulosis, defined as the presence of asymptomatic diverticula, (ii) symptomatic uncomplicated diverticular disease (SUDD) characterized by persistent abdominal pain, alterations in bowel habits, and absence of obvious diverticular inflammation, (iii) diverticulitis is caused by inflammation of the diverticula.…”

“…DD includes a range of diseases with different manifestations involving the presence of diverticula such as (i) diverticulosis, defined as the presence of asymptomatic diverticula, (ii) symptomatic uncomplicated diverticular disease (SUDD) characterized by persistent abdominal pain, alterations in bowel habits, and absence of obvious diverticular inflammation, (iii) diverticulitis is caused by inflammation of the diverticula. Diverticulitis can be further classified as uncomplicated when diverticular inflammation is localized or complicated when it is associated with other conditions such as fistula, bowel obstruction, perforations, bleeding, and abscesses [6,7].…”

“…Several identified risk factors might play an important role in the increased incidence of diverticulosis. These include genetic predispositions compounded by changes in diet, lifestyle, and prescription drugs (reviewed in detail [6,7,10]). However, the influence of these factors on inflammation and its role in the pathogenesis of DD remains to be understood.…”

Rifamycin vs placebo for the treatment of acute uncomplicated diverticulitis: A randomised, double‐blind study

“…[8][9][10][11] However, two randomised clinical trials and several observational studies have challenged the need for antibiotic treatment for patients with AUD. [12][13][14][15] Based on these findings, and growing concerns regarding widespread bacterial resistance, 11 a decline in the discovery of new antibiotics and multidrug resistance, several European guidelines no longer recommend routine antibiotic treatment for uncomplicated diverticulitis. 16,17 A recent international consensus on diverticular disease noted that treatment of AUD without antibiotics is safe and effective, and is not associated with worse outcomes than treatment with antibiotics; both this consensus and the 2020 European Society of Coloproctology guidelines recommend that antibiotics only need to be considered in immunocompromised patients and those with comorbidities and/or sepsis.…”