Chronic gastrointestinal symptoms may not improve with surgery. Factors to consider include disease severity, patient preferences and values, and the benefits and risks. Surgeons should advise elective segmental resection on a case-by-case basis rather than on a specific number of episodes. Guidelines around surgery have also changed. “Now we understand it involves inflammation, which does not necessarily need antibiotics.”ĪGA does, however, advise antibiotic treatment for patients with comorbidities, who present with concerning, high-risk symptoms or who present with complicated diverticulitis.Ĭaption: “Pouches” that form in the colon wall is typical of diverticulosis. “We always thought acute cases involved an immediate infection,” Dr.
“While antibiotics have long been first-line therapy for acute uncomplicated diverticulitis, recent evidence suggests there is no benefit in immunocompetent patients with mild acute uncomplicated diverticulitis,” the report states. One notable change: AGA recommends selective, rather than routine, antibiotic use in immunocompetent patients with mild disease. “They will influence my prescribing style and approach to surgery.” “The AGA guidelines reinforce the need for personalized care,” says Trevor Teetor, MD, colorectal surgeon and assistant professor of Colon and Rectal Surgery at Case Western Reserve University School of Medicine.
In light of these updated guidelines, University Hospitals Digestive Disease Institute has modified its approach to ensure patients receive the most up-to-date, comprehensive care possible. Guidelines from the American Society of Colon and Rectal Surgeons (ASCRS) echo AGA’s recommendations. While complicated cases require aggressive treatment, recent American Gastroenterological Association (AGA) guidelines suggest a more conservative approach for uncomplicated, nonsevere diverticulitis. Innovations in Digestive Health | Winter 2021Ĭolonic diverticulitis remains a painful, unpredictable gastrointestinal disease that can lead to serious complications, chronic symptoms and poor quality of life. Treatment moves toward less use of antibiotics, less emphasis on surgery
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