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United States Guidelines for Diverticulitis Treatment

Floch, Martin H. MD; Longo, Walter E. MD

Journal of Clinical Gastroenterology: October 2016 - Volume 50 - Issue - p S53–S56
doi: 10.1097/MCG.0000000000000668

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. The age and gender distribution is described. They are most common in the sigmoid. The guidelines of management are described according to accepted classification of the disease at all stages from onset, to early formation, to mild disease, to complicated disease, to rare specific states. The outcomes and mortality are discussed.

Departments of *Internal Medicine, Section of Digestive Diseases

Surgery, Gastrointestinal/Oncology, Yale University School of Medicine, New Haven, CT

The authors declare that they have nothing to disclose.

Address correspondence to: Martin H. Floch, MD, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06850 (e-mail:

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.