Diverticulitis

Jason Hall, MD, MPH, FACS, FACRS

Our understanding of the pathophysiology and management of diverticular disease of the colon continues to evolve at a rapid pace. The study of the natural history of diverticulitis has led to the understanding that this disease may have fundamentally different mechanisms than those proposed in previous generations. Genetics, the microbiome, and environmental risk factors are increasingly recognized as major contributors to the evolution of diverticulosis and subsequent progression to complicated diverticulitis.

While the underlying translational science has evolved, our treatment of the disease has radically changed. The role of antibiotics in the treatment of patients with uncomplicated diverticulitis has been questioned. A majority of patients in industrialized nations can now be treated as outpatients for mild diverticular attacks. The role of the surgeon in the management of this disease has also changed. We are challenged with providing minimally techniques to patients at all stages of the disease. The role of surgical management after the resolution of uncomplicated or complicated disease continues to be hotly debated.

This issue of the Clinics in Colon and Rectal Surgery will illuminate areas of controversy in the pathophysiology and management of this disease. There are a number of well-performed observational or randomized controlled trials that provide us with some guidance as we find better ways to care for patients with this disease. This publication is intended to illuminate the various options available to surgeons and is not intended to be prescriptive.

Publication History

Article published online:
24 February 2021