AGA Family of Websites: Gastro.org
Guideline

Management of acute diverticulitis

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Recommendations for all aspects of the management of acute uncomplicated diverticulitis, from follow-up colonoscopies to medications to diet and lifestyle interventions.

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Recommendations

1. AGA suggests that antibiotics should be used selectively, rather than routinely, in patients with acute uncomplicated diverticulitis.

2. AGA suggests that colonoscopy be performed after resolution of acute diverticulitis in appropriate candidates to exclude the misdiagnosis of a colonic neoplasm if a high-quality examination of the colon has not been recently performed.

3. AGA suggests against elective colonic resection in patients with an initial episode of acute uncomplicated diverticulitis. The decision to perform elective prophylactic colonic resection in this setting should be individualized.

4. AGA suggests a fiber-rich diet or fiber supplementation in patients with a history of acute diverticulitis.

5. AGA suggests against routinely advising patients with a history of diverticulitis to avoid consumption of seeds, nuts and popcorn.

6. AGA suggests against routinely advising patients with a history of diverticulitis to avoid the use of aspirin.

7. AGA suggests advising patients with a history of diverticulitis to avoid the use of nonaspirin NSAIDs if possible.

8. AGA recommends against the use of mesalamine after acute uncomplicated diverticulitis.

9. AGA suggests against the use of rifaximin after acute uncomplicated diverticulitis.

10. AGA suggests against the use of probiotics after acute uncomplicated diverticulitis.

11. AGA suggests advising patients with diverticular disease to consider vigorous physical activity.

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