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diverticulitis guidelines

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https://www.readbyqxmd.com/read/28808771/multicentre-controlled-randomized-clinical-trial-to-compare-the-efficacy-and-safety-of-ambulatory-treatment-of-mild-acute-diverticulitis-without-antibiotics-with-the-standard-treatment-with-antibiotics
#1
Laura Mora Lopez, Neus Ruiz-Edo, Sheila Serra Pla, Anna Pallisera Llovera, Salvador Navarro Soto, Xavier Serra-Aracil
PURPOSE: Acute diverticulitis (AD) is a highly prevalent disease in Spain. Its chronic-recurrent appearance and high rate of relapse mean that it has a major epidemiological and economic impact on our health system. In spite of this, it has not been studied in any great depth. Reassessing its etiopathology, recent studies have observed that it is an inflammatory disease-not, as classic theories had postulated, an infectious one. In the light of these findings, the suitability of antibiotics for its treatment has been reconsidered...
August 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28799055/risk-factors-for-complicated-diverticulitis-systematic-review-and-meta-analysis
#2
REVIEW
H E Bolkenstein, B J M van de Wall, E C J Consten, I A M J Broeders, W A Draaisma
PURPOSE: The aim of this systematic review is to identify risk factors that can predict complicated diverticulitis. Uncomplicated diverticulitis is a self-limiting and mild disease, but 10% of patients with diverticulitis develop complications requiring further treatment. It is important to estimate the risk of developing complicated diverticulitis at an early stage to set the right treatment at initial presentation. METHODS: Embase, MEDLINE, and Cochrane databases were searched for studies reporting on risk factors for complicated diverticulitis...
August 10, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28630808/management-of-acute-uncomplicated-diverticulitis-may-exclude-antibiotic-therapy
#3
REVIEW
Jonathan Mayl, Mikhail Marchenko, Emily Frierson
Diverticulitis is a common ailment that is prevalent in the developed world. As such, the management of diverticulitis places a substantial economic burden on healthcare. Research is ongoing to further elucidate both the pathogenesis of the disease, as well as ways to reduce associated expenditures. One of these emerging areas of research calls into question the use of antibiotics during treatment of acute uncomplicated diverticulitis. Current guidelines are largely based on expert opinion, with little evidence supporting the standard practice of antibiotic therapy...
May 15, 2017: Curēus
https://www.readbyqxmd.com/read/28608041/laparoscopic-lavage-in-the-management-of-perforated-diverticulitis-a-contemporary-meta-analysis
#4
Norman Galbraith, Jane V Carter, Uri Netz, Dongyan Yang, Donald E Fry, Michael McCafferty, Susan Galandiuk
IMPORTANCE: Perforated diverticulitis carries the risk of significant comorbidity and mortality. Although colon resection provides adequate source control, the procedure itself carries morbidity, as well as later stoma reversal procedures. The effectiveness of laparoscopic lavage to treat perforated diverticulitis remains unclear. OBJECTIVE: We aimed to conduct a meta-analysis to evaluate current studies comparing laparoscopic lavage with colon resection in cases of perforated diverticulitis for the effectiveness in source control, without the need for subsequent interventions, stoma formation, and death...
June 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28547682/adherence-to-clinical-guidelines-and-the-potential-economic-benefits-of-admission-avoidance-for-acute-uncomplicated-diverticulitis
#5
I S Reynolds, E O'Connell, R M Heaney, W Khan, I Z Khan, R Waldron, K Barry
BACKGROUND: The treatment paradigm for acute diverticulitis is changing. There is an increasing trend towards managing patients with uncomplicated diverticulitis in the community. AIMS: The aim of this study was to analyse how acute diverticulitis is managed in our institution and also to analyse national data pertaining to treatment of acute diverticulitis. METHODS: A prospective database of all patients admitted to our institution over a 2-year period (2014-2016) with acute diverticulitis was maintained...
May 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28473679/epiploic-appendagitis-an-uncommon-surgical-diagnosis
#6
A Michael, Y Zakry, H Hanif
Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients...
April 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28453588/-diverticular-disease-myths-and-realities
#7
REVIEW
Daniela Fluxá, Rodrigo Quera
Diverticulosis and diverticular disease of the colon are common conditions in Western countries. The incidence and prevalence of these diseases are increasing and becoming significant for health systems. A growing body of knowledge is shifting the paradigm of the pathogenesis and treatment of diverticular disease. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors leading to diverticular disease. The risk of developing diverticulitis among individuals with diverticulosis is lower than 10 to 25%...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28416195/pitavastatin-versus-pravastatin-in-adults-with-hiv-1-infection-and-dyslipidaemia-intrepid-12-week-and-52-week-results-of-a-phase-4-multicentre-randomised-double-blind-superiority-trial
#8
Judith A Aberg, Craig A Sponseller, Douglas J Ward, Vladimir A Kryzhanovski, Stuart E Campbell, Melanie A Thompson
BACKGROUND: People living with HIV-1 infection are at greater risk for cardiovascular disease than seronegative adults. Treatment of dyslipidaemia with statins has been challenging in people with HIV because of an increased potential for drug interactions due to competing cytochrome P450 metabolism between statins and commonly used antiretroviral agents. Neither pitavastatin nor pravastatin depend on cytochrome P450 for primary metabolism. We aimed to assess the safety and efficacy of pitavastatin versus pravastatin in adults with HIV and dyslipidaemia...
July 2017: Lancet HIV
https://www.readbyqxmd.com/read/28240005/surgery-for-diverticulitis-in-the-21st-century-recent-evidence
#9
Arden M Morris, Cindy Kin
Sigmoid diverticulitis is an increasingly common disease in Western countries. As technology has led to increased knowledge about the disease and options for treatment, management strategies have become less certain. In previous years, the rationale for early elective surgery was largely preventive, due to concern that diverticulitis recurrence would result in increased risk of sepsis or the need for a colostomy. New technology has enabled diagnosis, through computed tomography scans, predictive information through clinical and administrative databases, and less invasive treatment options, through laparoscopic techniques...
June 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28197792/laparoscopic-lavage-versus-surgical-resection-for-acute-diverticulitis-with-generalised-peritonitis-a-systematic-review-and-meta-analysis
#10
REVIEW
R Cirocchi, S Di Saverio, D G Weber, R Taboła, I Abraha, J Randolph, A Arezzo, G A Binda
This systematic review and meta-analysis investigates current evidence on the therapeutic role of laparoscopic lavage in the management of diverticular peritonitis. A systematic review of the literature was performed on PubMed until June 2016, according to preferred reporting items for systematic reviews and meta-analyses guidelines. All randomised controlled trials comparing laparoscopic lavage with surgical resection, irrespective of anastomosis or stoma formation, were analysed. After assessment of titles and full text, 3 randomised trials fulfilled the inclusion criteria...
February 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#11
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
April 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28035461/is-early-colonoscopy-after-ct-diagnosed-diverticulitis-still-necessary
#12
Thomas Surya Suhardja, Shana Norhadi, Edward Zhenyu Seah, Stephen Rodgers-Wilson
PURPOSE: WHO GLOBOCAN 2012 data showed that Australia and New Zealand have the highest incidence rates of colorectal cancer in the world (Ferlay et al. 1). Current guidelines recommend that patients admitted for an episode of acute diverticulitis require an early follow-up colonoscopy to rule out colorectal malignancy as reported by Fozard et al. (Colorectal Dis 13:1-11, 2011). Recent studies however have indicated that this may not be warranted (Brar et al. Dis Colon rectum 56:1259-1264, 2013)...
April 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27973463/rationale-and-evidences-for-treatment-of-symptomatic-uncomplicated-diverticular-disease
#13
Rosario Cuomo, Martina Cargiolli, Paolo Andreozzi, Francesco P Zito, Giovanni Sarnelli
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...
June 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27941344/routine-colonoscopy-after-acute-uncomplicated-diverticulitis-challenging-a-putative-indication
#14
Patrícia Andrade, Armando Ribeiro, Rosa Ramalho, Susana Lopes, Guilherme Macedo
BACKGROUND AND AIMS: Most international guidelines recommend performing a routine colonoscopy after the conservative management of acute diverticulitis, mainly to rule out a colorectal malignancy; however, data to support these recommendations are scarce and conflicting. This study is aimed at determining the rate of advanced colonic neoplasia (ACN) found by colonoscopy, and hence the need for routine colonoscopy after CT-diagnosed acute diverticulitis. METHODS: We retrospectively analyzed all patients hospitalized for acute diverticulitis between July 2008 and June 2013...
2017: Digestive Surgery
https://www.readbyqxmd.com/read/27830672/an-approach-to-complicated-diverticular-disease-a-retrospective-study-in-an-acute-care-surgery-service-recently-established
#15
Savino Occhionorelli, Monica Zese, Daniela Tartarini, Domenica Lacavalla, Stefano Maccatrozzo, Giacomo Groppo, Maria Grazia Sibilla, Rocco Stano, Lorenzo Cappellari, Giorgio Vasquez
AIM: Acute diverticulitis is a frequent disease in the Western Countries. The increase number of patients admitted in the Surgery Departments led the necessity of new Scores and Classifications in order to clarify, in absence of clear guidelines, the best treatments to offer in the different situations. METHODS: A retrospective study of ninety-nine patients treated in our Department from June 2010 and March 2015. RESULTS: In our study 41 patients were treated conservatively, the remaining 58 were operated, 56 laparotomic and 2 laparoscopic...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27686365/randomized-clinical-trial-of-observational-versus-antibiotic-treatment-for-a-first-episode-of-ct-proven-uncomplicated-acute-diverticulitis
#16
RANDOMIZED CONTROLLED TRIAL
L Daniels, Ç Ünlü, N de Korte, S van Dieren, H B Stockmann, B C Vrouenraets, E C Consten, J A van der Hoeven, Q A Eijsbouts, I F Faneyte, W A Bemelman, M G Dijkgraaf, M A Boermeester
BACKGROUND: Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. METHODS: Patients with CT-proven, primary, left-sided, uncomplicated, acute diverticulitis were included at 22 clinical sites in the Netherlands, and assigned randomly to an observational or antibiotic treatment strategy...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/27622377/the-management-of-patients-with-diverticulosis-and-diverticular-disease-in-primary-care-an-online-survey-among-italian-general-pratictioners
#17
Rudi De Bastiani, Guido Sanna, Pierluigi Fracasso, Maurizio D'Urso, Edoardo Benedetto, Antonio Tursi
GOALS: To investigate the current opinion of Italian general practitioners (GPs) on the management of patients with diverticular disease (DD) of the colon. BACKGROUND: The management of DD remains a point of debate, and guidelines are not uniform in their advice. STUDY: A web-based survey was conducted among Italian GPs. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. RESULTS: In total, 245 surveys were filled out...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622374/when-should-we-operate-for-recurrent-diverticulitis
#18
Savvas Papagrigoriadis
Recent guidelines on elective surgery for recurrent diverticulitis have removed generalized recommendations for elective preventive surgery and advice individualized decision per patient. We discuss the clinical evidence and potential use of risk factors to help with decision-making for patient selection for elective surgery in the presence of a history of diverticulitis.
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622371/probiotics-for-the-treatment-of-symptomatic-uncomplicated-diverticular-disease-rationale-and-current-evidence
#19
Carmelo Scarpignato, Anna Bertelé, Antonio Tursi
Changes in the colonic microbiota are critical to the pathogenesis of diverticular complications such as diverticulitis and peridiverticular abscesses. However, more subtle changes in microbiota composition may well be important to the more chronic manifestations of diverticulosis. Some studies have shown the presence of bacterial overgrowth in subgroups of patients with diverticular disease and recent studies, using molecular biology techniques, found an increase of proteobacteria and actinobacteria in patients with symptomatic uncomplicated diverticular disease (SUDD), compared with healthy controls...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622366/united-states-guidelines-for-diverticulitis-treatment
#20
Martin H Floch, Walter E Longo
Guidelines for diverticular disease management were last supported and published by the American Gastroenterology Association and the American College of Gastroenterology 2 decades ago. Guidelines have been published in other countries and by some societies. These guidelines are suggested as United States of America guidelines. In reality, they are what is practiced in Connecticut at Yale New Haven hospitals. The epidemiology and pathophysiology is described. This is still considered a dietary fiber-deficiency disease that results in high intracolonic pressure with resultant outpocketing of diverticula in the weakest point of the colon at the sites of vascular penetration with developing elastin deposition in the colon wall...
October 2016: Journal of Clinical Gastroenterology
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