Paradigm shift: the Copernican revolution in diverticular disease.
Diverticular disease
complications
diagnosis
pathogenesis
Journal
Annals of gastroenterology
ISSN: 1108-7471
Titre abrégé: Ann Gastroenterol
Pays: Greece
ID NLM: 101121847
Informations de publication
Date de publication:
Historique:
received:
05
05
2019
accepted:
26
06
2019
entrez:
9
11
2019
pubmed:
9
11
2019
medline:
9
11
2019
Statut:
ppublish
Résumé
Diverticular disease (DD) is an umbrella definition that includes different clinical conditions ranging from diverticulosis to severe and potentially life-threatening complications. In the last decade, new concepts regarding pathogenetic alterations have been developed, while the diagnostic, clinical and therapeutic approaches to the management of DD patients have changed. The protective role of dietary factors (i.e., fiber) has been questioned, whilst some drugs widely used in clinical practice have been found to have a deleterious effect. The use of antibiotics in all patients with acute uncomplicated diverticulitis was reconsidered, as well as the need for a surgical approach in these patients. Conflicting recommendations in different guidelines were proposed for the treatment of symptomatic uncomplicated DD. An endoscopic classification of DD was introduced, and a "curative" endoscopic approach has been pioneered. Based on these observations, which together amount to a kind of "Copernican revolution" in the management of DD patients, we performed a comprehensive and critical reappraisal of the proposed modifications, aiming to discriminate between certainties and doubts on this issue.
Identifiants
pubmed: 31700230
doi: 10.20524/aog.2019.0410
pii: AnnGastroenterol-32-541
pmc: PMC6826076
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
541-553Informations de copyright
Copyright: © Hellenic Society of Gastroenterology.
Déclaration de conflit d'intérêts
Conflict of Interest: None
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