Diverticular disease and its complications: Epidemiology, natural history and medical treatment

Diverticular disease of the colon (DD) is common in western industrialized countries. Diet and life style are considered to be the main contributing factors for the development of the disease. It has been suggested that low fibre intake promotes diverticular formation and alters the intestinal flora, so transforming asymptomatic diverticular disease into diverticulitis. DD may be asymptomatic, symptomatic, uncomplicated diverticulitis or complicated diverticulitis. Treatment depends on clinical presentation. This paper is a review of the epidemiology, natural history and medical treatment of diverticular disease, emphasizing the use of non-absorbable antibiotics and the recent advent of mesalazine and probiotics for the management of DD patients.