title: Diverticula and Diverticulitis: Time for a Reappraisal.
abstract: Colonic diverticula are very common and may be associated with symptoms or complicated by diverticulitis and its associated problems. Many of the traditional concepts relating to the pathophysiology, prevention, and management of these entities have been questioned recently based on findings from high-quality prospective studies. Although dietary fiber may protect against symptoms and complications, its impact on the formation of diverticula may be limited. It is now evident that the risk for an episode of diverticulitis in an individual with diverticula is lower than previously thought. Furthermore, the necessity for antibiotic use in uncomplicated diverticulitis has been questioned and serious doubt cast upon the belief that surgery should be performed when a second attack occurs. Although data are far from conclusive, there is some evidence to suggest that diverticulosis may be associated with chronic abdominal symptoms, with or without underlying chronic inflammatory changes in the involved segment of the colon. In addition, colonoscopy is not routinely required after an attack of acute uncomplicated diverticulitis, as the risk of cancer in this population is not much higher than in the general population.
authors.affiliation: Dr Barroso is an associate professor and Dr Quigley is a professor in the Division of Gastroenterology and Hepatology at the Lynda K. and David M. Underwood Center for Digestive Disorders at Houston Methodist Hospital and Weill Cornell Medical College in Houston, Texas.
authors.forename: Alberto O
authors.initials: AO
authors.lastname: Barroso
authors.affiliation: Dr Barroso is an associate professor and Dr Quigley is a professor in the Division of Gastroenterology and Hepatology at the Lynda K. and David M. Underwood Center for Digestive Disorders at Houston Methodist Hospital and Weill Cornell Medical College in Houston, Texas.
authors.forename: Eamonn M M
authors.initials: EM
authors.lastname: Quigley
keywords: Diverticulosis; antibiotics; diverticula; diverticular disease; diverticulitis; fiber; surgery