American Gastroenterological Association Institute Technical Review on the Management of Acute Diverticulitis

Gastroenterology

Volumn 149, Issue 7, 2015, Pages 1950-1976.e12

  Strate, Lisa L ^a   Peery, Anne F ^b   Neumann, Ignacio ^c,d  

^a UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

^c PONTIFICIA UNIVERSIDAD CATÓLICA DE CHILE   (Chile)

^d MCMASTER UNIVERSITY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ANTIBIOTIC AGENT; MESALAZINE; NONSTEROID ANTIINFLAMMATORY AGENT; RIFAXIMIN; ANTIINFECTIVE AGENT; GASTROINTESTINAL AGENT;

ACUTE DISEASE; ACUTE DIVERTICULITIS; COLON RESECTION; COLONOSCOPY; COMPUTER ASSISTED TOMOGRAPHY; CULTURAL VALUE; DIAGNOSTIC ERROR; DIET THERAPY; DIVERTICULITIS; ELECTIVE SURGERY; HIGH FIBER DIET; HUMAN; LIFESTYLE MODIFICATION; MAIZE; MEDICAL HISTORY; NUT; OUTCOME ASSESSMENT; PATIENT PREFERENCE; PHYSICAL ACTIVITY; PRIORITY JOURNAL; REVIEW; DIET; GASTROENTEROLOGY; STANDARDS;

ANTI-BACTERIAL AGENTS; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; COLECTOMY; DIET; DIVERTICULITIS; GASTROENTEROLOGY; GASTROINTESTINAL AGENTS; HUMANS; MESALAMINE;

EID: 84952888605     PISSN: 00165085     EISSN: 15280012     Source Type: Journal    
DOI: 10.1053/j.gastro.2015.10.001     Document Type: Article

References (125)

1. A.F. Peery, P.R. Barrett, D. Park, and et al. A high-fiber diet does not protect against asymptomatic diverticulosis Gastroenterology 142 2012 266 272 e1
2. K. Shahedi, G. Fuller, R. Bolus, and et al. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy Clin Gastroenterol Hepatol 11 2013 1609 1613
3. P. Ambrosetti, R. Chautems, C. Soravia, and et al. Long-term outcome of mesocolic and pelvic diverticular abscesses of the left colon: a prospective study of 73 cases Dis Colon Rectum 48 2005 787 791
4. D.A. Anaya, and D.R. Flum Risk of emergency colectomy and colostomy in patients with diverticular disease Arch Surg 140 2005 681 685
5. G. Broderick-Villa, R.J. Burchette, J.C. Collins, and et al. Hospitalization for acute diverticulitis does not mandate routine elective colectomy Arch Surg 140 2005 576 581 discussion 581-583
6. J.F. Hall, P.L. Roberts, R. Ricciardi, and et al. Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence? Dis Colon Rectum 54 2011 283 288
7. D.O. Jacobs Clinical practice. Diverticulitis N Engl J Med 357 2007 2057 2066
8. D.A. Etzioni, T.M. Mack, R.W. Beart Jr., and et al. Diverticulitis in the United States: 1998-2005: changing patterns of disease and treatment Ann Surg 249 2009 210 217
9. J.Y. Kang, J. Hoare, A. Tinto, and et al. Diverticular disease of the colon - on the rise: a study of hospital admissions in England between 1989/1990 and 1999/2000 Aliment Pharmacol Ther 17 2003 1189 1195
10. D. Feingold, S.R. Steele, S. Lee, and et al. Practice parameters for the treatment of sigmoid diverticulitis Dis Colon Rectum 57 2014 284 294
11. P. Ambrosetti, A. Jenny, C. Becker, and et al. Acute left colonic diverticulitis - compared performance of computed tomography and water-soluble contrast enema: prospective evaluation of 420 patients Dis Colon Rectum 43 2000 1363 1367
12. W. Lameris, A. van Randen, S. Bipat, and et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy Eur Radiol 18 2008 2498 2511
13. A.F. Peery, E.S. Dellon, J. Lund, and et al. Burden of gastrointestinal disease in the United States: 2012 update Gastroenterology 143 2012 1179 1187 e1-3
14. E. Cohen, G. Fuller, R. Bolus, and et al. Increased risk for irritable bowel syndrome after acute diverticulitis Clin Gastroenterol Hepatol 11 2013 1614 1619
15. B.M. Spiegel, M.W. Reid, R. Bolus, and et al. Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL Qual Life Res 24 2015 163 179
16. A. Chabok, L. Pahlman, F. Hjern, and et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis Br J Surg 99 2012 532 539
17. L. Salem, D.L. Veenstra, S.D. Sullivan, and et al. The timing of elective colectomy in diverticulitis: a decision analysis J Am Coll Surg 199 2004 904 912
18. M. Freeman, and J. Tukey Transformations related to the angular and the square root Ann Math Stat 21 1950 607 611
19. R.L. Grant Converting an odds ratio to a range of plausible relative risks for better communication of research findings BMJ 348 2014 f7450
20. J. Miller The inverse of the Freeman-Tukey double arcsine transformation Am Stat 32 1978 138
21. G. Guyatt, A.D. Oxman, E.A. Akl, and et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables J Clin Epidemiol 64 2011 383 394
22. A. Carrasco-Labra, R. Brignardello-Petersen, N. Santesso, and et al. Comparison between the standard and a new alternative format of the Summary-of-Findings tables in Cochrane review users: study protocol for a randomized controlled trial Trials 16 2015 164
23. D.M. Shabanzadeh, and P. Wille-Jorgensen Antibiotics for uncomplicated diverticulitis Cochrane Database Syst Rev 11 2012 CD009092
24. A.M. Morris, S.E. Regenbogen, K.M. Hardiman, and et al. Sigmoid diverticulitis: a systematic review JAMA 311 2014 287 297
25. C. Unlu, N. de Korte, L. Daniels, and et al. A multicenter randomized clinical trial investigating the cost-effectiveness of treatment strategies with or without antibiotics for uncomplicated acute diverticulitis (DIABOLO trial) BMC Surg 10 2010 23
26. L.U.C. Daniels, N. de Korte, and et al. A randomized clinical trial of observational versus antibiotic treatment for a first episode of uncomplicated acute diverticulitis United European Gastroenterol J 2 1S 2014 A2
27. J. Rafferty, P. Shellito, N.H. Hyman, and et al. Practice parameters for sigmoid diverticulitis Dis Colon Rectum 49 2006 939 944
28. N.H. Stollman, and J.B. Raskin Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology Am J Gastroenterol 94 1999 3110 3121
29. M.H. Floch A hypothesis: is diverticulitis a type of inflammatory bowel disease? J Clin Gastroenterol 40 suppl 3 2006 S121 S125
30. N. de Korte, J.P. Kuyvenhoven, D.L. van der Peet, and et al. Mild colonic diverticulitis can be treated without antibiotics. A case-control study Colorectal Dis 14 2012 325 330
31. F. Hjern, T. Josephson, D. Altman, and et al. Conservative treatment of acute colonic diverticulitis: are antibiotics always mandatory? Scand J Gastroenterol 42 2007 41 47
32. L. Daniels, C. Unlu, T.R. de Wijkerslooth, and et al. Routine colonoscopy after left-sided acute uncomplicated diverticulitis: a systematic review Gastrointest Endosc 79 2014 378 389 quiz 498-498 e5
33. G. Arora, A. Mannalithara, G. Singh, and et al. Risk of perforation from a colonoscopy in adults: a large population-based study Gastrointest Endosc 69 2009 654 664
34. P.V. Sharma, T. Eglinton, P. Hider, and et al. Systematic review and meta-analysis of the role of routine colonic evaluation after radiologically confirmed acute diverticulitis Ann Surg 259 2014 263 272
35. H.S. de Vries, D. Boerma, R. Timmer, and et al. Routine colonoscopy is not required in uncomplicated diverticulitis: a systematic review Surg Endosc 28 2014 2039 2047
36. L.W. Day, A. Kwon, J.M. Inadomi, and et al. Adverse events in older patients undergoing colonoscopy: a systematic review and meta-analysis Gastrointest Endosc 74 2011 885 896
37. D.A. Westwood, T.W. Eglinton, and F.A. Frizelle Routine colonoscopy following acute uncomplicated diverticulitis Br J Surg 98 2011 1630 1634
38. A. Elmi, S.S. Hedgire, V. Pargaonkar, and et al. Is early colonoscopy beneficial in patients with CT-diagnosed diverticulitis? AJR Am J Roentgenol 200 2013 1269 1274
39. K.C. Lau, K. Spilsbury, Y. Farooque, and et al. Is colonoscopy still mandatory after a CT diagnosis of left-sided diverticulitis: can colorectal cancer be confidently excluded? Dis Colon Rectum 54 2011 1265 1270
40. A. Lahat, Y. Menachem, B. Avidan, and et al. Diverticulitis in the young patient - is it different? World J Gastroenterol 12 2006 2932 2935
41. C.M. Rutter, E. Johnson, D.L. Miglioretti, and et al. Adverse events after screening and follow-up colonoscopy Cancer Causes Control 23 2012 289 296
42. S. Singh, P.P. Singh, M.H. Murad, and et al. Prevalence, risk factors, and outcomes of interval colorectal cancers: a systematic review and meta-analysis Am J Gastroenterol 109 2014 1375 1389
43. T. Stefansson, A. Ekbom, P. Sparen, and et al. Association between sigmoid diverticulitis and left-sided colon cancer: a nested, population-based, case control study Scand J Gastroenterol 39 2004 743 747
44. T. Stefansson, A. Ekbom, P. Sparen, and et al. Increased risk of left sided colon cancer in patients with diverticular disease Gut 34 1993 499 502
45. J. Granlund, T. Svensson, F. Granath, and et al. Diverticular disease and the risk of colon cancer - a population-based case-control study Aliment Pharmacol Ther 34 2011 675 681
46. W.Y. Huang, C.C. Lin, Y.M. Jen, and et al. Association between colonic diverticular disease and colorectal cancer: a nationwide population-based study Clin Gastroenterol Hepatol 12 2014 1288 1294
47. S. Biondo, J.L. Borao, E. Kreisler, and et al. Recurrence and virulence of colonic diverticulitis in immunocompromised patients Am J Surg 204 2012 172 179
48. S. Biondo, D. Pares, J. Marti Rague, and et al. Acute colonic diverticulitis in patients under 50 years of age Br J Surg 89 2002 1137 1141
49. T. Eglinton, T. Nguyen, S. Raniga, and et al. Patterns of recurrence in patients with acute diverticulitis Br J Surg 97 2010 952 957
50. G.R. Faria, A.B. Almeida, H. Moreira, and et al. Acute diverticulitis in younger patients: any rationale for a different approach? World J Gastroenterol 17 2011 207 212
51. F. Hjern, T. Josephson, D. Altman, and et al. Outcome of younger patients with acute diverticulitis Br J Surg 95 2008 758 764
52. D.W. Larson, N.J. Batdorf, J.G. Touzios, and et al. A fast-track recovery protocol improves outcomes in elective laparoscopic colectomy for diverticulitis J Am Coll Surg 211 2010 485 489
53. J. Lopez-Borao, E. Kreisler, M. Millan, and et al. Impact of age on recurrence and severity of left colonic diverticulitis Colorectal Dis 14 2012 e407 e412
54. S. Shaikh, and Z.H. Krukowski Outcome of a conservative policy for managing acute sigmoid diverticulitis Br J Surg 94 2007 876 879
55. W. Raue, V. Paolucci, W. Asperger, and et al. Laparoscopic sigmoid resection for diverticular disease has no advantages over open approach: midterm results of a randomized controlled trial Langenbecks Arch Surg 396 2011 973 980
56. B.R. Klarenbeek, A.A. Veenhof, R. Bergamaschi, and et al. Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: a randomized control trial: short-term results of the Sigma Trial Ann Surg 249 2009 39 44
57. P. Gervaz, I. Inan, T. Perneger, and et al. A prospective, randomized, single-blind comparison of laparoscopic versus open sigmoid colectomy for diverticulitis Ann Surg 252 2010 3 8
58. C. Andeweg, J. Peters, R. Bleichrodt, and et al. Incidence and risk factors of recurrence after surgery for pathology-proven diverticular disease World J Surg 32 2008 1501 1506
59. K. Thaler, E.G. Weiss, J.J. Nogueras, and et al. Recurrence rates at minimum 5-year follow-up: laparoscopic versus open sigmoid resection for uncomplicated diverticulitis Surg Laparosc Endosc Percutan Tech 13 2003 325 327
60. S.E. Regenbogen, K.M. Hardiman, S. Hendren, and et al. Surgery for diverticulitis in the 21st century: a systematic review JAMA Surg 149 2014 292 303
61. D. Antolovic, C. Reissfelder, M. Koch, and et al. Surgical treatment of sigmoid diverticulitis-analysis of predictive risk factors for postoperative infections, surgical complications, and mortality Int J Colorectal Dis 24 2009 577 584
62. S.Y. Boostrom, B.G. Wolff, R.R. Cima, and et al. Uncomplicated diverticulitis, more complicated than we thought J Gastrointest Surg 16 2012 1744 1749
63. B.R. Klarenbeek, M. Samuels, M.A. van der Wal, and et al. Indications for elective sigmoid resection in diverticular disease Ann Surg 251 2010 670 674
64. A.O. Lidor, E. Schneider, J. Segal, and et al. Elective surgery for diverticulitis is associated with high risk of intestinal diversion and hospital readmission in older adults J Gastrointest Surg 14 2010 1867 1873 discussion 1873-1874
65. A. Forgione, J. Leroy, R.A. Cahill, and et al. Prospective evaluation of functional outcome after laparoscopic sigmoid colectomy Ann Surg 249 2009 218 224
66. A. Campos, E. Grzona, F. Carballo, and et al. Does sigmoidectomy for recurrent diverticulitis have an impact on patients' quality of life? Dis Colon Rectum 56 2013 e124
67. B.J. van de Wall, W.A. Draaisma, E.C. Consten, and et al. DIRECT trial. Diverticulitis recurrences or continuing symptoms: operative versus conservative treatment. A multicenter randomised clinical trial BMC Surg 10 2010 25
68. D.J. Humes, and J. West Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK: population-based cohort study Gut 61 2012 95 100
69. J. Freischlag, R.S. Bennion, and J.E. Thompson Jr. Complications of diverticular disease of the colon in young people Dis Colon Rectum 29 1986 639 643
70. R.C. Chautems, P. Ambrosetti, A. Ludwig, and et al. Long-term follow-up after first acute episode of sigmoid diverticulitis: is surgery mandatory? A prospective study of 118 patients Dis Colon Rectum 45 2002 962 966
71. Y. Reisman, Y. Ziv, D. Kravrovitc, and et al. Diverticulitis: the effect of age and location on the course of disease Int J Colorectal Dis 14 1999 250 254
72. H. Spivak, S. Weinrauch, J.C. Harvey, and et al. Acute colonic diverticulitis in the young Dis Colon Rectum 40 1997 570 574
73. J.D. Perkins, C.F. Shield III, F.C. Chang, and et al. Acute diverticulitis. Comparison of treatment in immunocompromised and nonimmunocompromised patients Am J Surg 148 1984 745 748
74. E.S. Tyau, J.B. Prystowsky, R.J. Joehl, and et al. Acute diverticulitis. A complicated problem in the immunocompromised patient Arch Surg 126 1991 855 858 discussion 858-859
75. P.L. Benn, B.G. Wolff, and D.M. Ilstrup Level of anastomosis and recurrent colonic diverticulitis Am J Surg 151 1986 269 271
76. R. Bergamaschi, and J.P. Arnaud Anastomosis level and specimen length in surgery for uncomplicated diverticulitis of the sigmoid Surg Endosc 12 1998 1149 1151
77. P. Ambrosetti, and P. Gervaz Laparoscopic elective sigmoidectomy for diverticular disease: a plea for standardization of the procedure Colorectal Dis 16 2014 90 94
78. B. Egger, M.K. Peter, and D. Candinas Persistent symptoms after elective sigmoid resection for diverticulitis Dis Colon Rectum 51 2008 1044 1048
79. M.M. Levack, L.R. Savitt, D.L. Berger, and et al. Sigmoidectomy syndrome? Patients' perspectives on the functional outcomes following surgery for diverticulitis Dis Colon Rectum 55 2012 10 17
80. F.L. Crowe, P.N. Appleby, N.E. Allen, and et al. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians BMJ 343 2011 d4131
81. A.L. Leahy, R.M. Ellis, D.S. Quill, and et al. High fibre diet in symptomatic diverticular disease of the colon Ann R Coll Surg Engl 67 1985 173 174
82. A.J. Brodribb Treatment of symptomatic diverticular disease with a high-fibre diet Lancet 1 1977 664 666
83. W.J. Hodgson The placebo effect. Is it important in diverticular disease? Am J Gastroenterol 67 1977 157 162
84. M.H. Ornstein, E.R. Littlewood, I.M. Baird, and et al. Are fibre supplements really necessary in diverticular disease of the colon? A controlled clinical trial Br Med J (Clin Res Ed) 282 1981 1353 1356
85. C. Unlu, L. Daniels, B.C. Vrouenraets, and et al. A systematic review of high-fibre dietary therapy in diverticular disease Int J Colorectal Dis 27 2012 419 427
86. W.H. Aldoori, E.L. Giovannucci, H.R. Rockett, and et al. A prospective study of dietary fiber types and symptomatic diverticular disease in men J Nutr 128 1998 714 719
87. L.L. Strate, Y.L. Liu, S. Syngal, and et al. Nut, corn, and popcorn consumption and the incidence of diverticular disease JAMA 300 2008 907 914
88. C.M. Albert, J.M. Gaziano, W.C. Willett, and et al. Nut consumption and decreased risk of sudden cardiac death in the Physicians' Health Study Arch Intern Med 162 2002 1382 1387
89. R. Jiang, J.E. Manson, M.J. Stampfer, and et al. Nut and peanut butter consumption and risk of type 2 diabetes in women JAMA 288 2002 2554 2560
90. L.L. Strate, Y.L. Liu, E.S. Huang, and et al. Use of aspirin or nonsteroidal anti-inflammatory drugs increases risk for diverticulitis and diverticular bleeding Gastroenterology 140 2011 1427 1433
91. L. Laine, S.P. Curtis, M. Langman, and et al. Lower gastrointestinal events in a double-blind trial of the cyclo-oxygenase-2 selective inhibitor etoricoxib and the traditional nonsteroidal anti-inflammatory drug diclofenac Gastroenterology 135 2008 1517 1525
92. A. Lanas, and F. Sopena Nonsteroidal anti-inflammatory drugs and lower gastrointestinal complications Gastroenterol Clin North Am 38 2009 333 352
93. K. Campbell, and R.J. Steele Non-steroidal anti-inflammatory drugs and complicated diverticular disease: a case-control study Br J Surg 78 1991 190 191
94. C.R. Morris, I.M. Harvey, W.S. Stebbings, and et al. Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease Br J Surg 90 2003 1267 1272
95. S. Mpofu, C.M. Mpofu, D. Hutchinson, and et al. Steroids, non-steroidal anti-inflammatory drugs, and sigmoid diverticular abscess perforation in rheumatic conditions Ann Rheum Dis 63 2004 588 590
96. N. Raju, M. Sobieraj-Teague, J. Hirsh, and et al. Effect of aspirin on mortality in the primary prevention of cardiovascular disease Am J Med 124 2011 621 629
97. D.J. Humes, K.M. Fleming, R.C. Spiller, and et al. Concurrent drug use and the risk of perforated colonic diverticular disease: a population-based case-control study Gut 60 2011 219 224
98. C.R. Morris, I.M. Harvey, W.S. Stebbings, and et al. Do calcium channel blockers and antimuscarinics protect against perforated colonic diverticular disease? A case control study Gut 52 2003 1734 1737
99. W. Kruis, T. Eisenbach, H. Lohr, and et al. Double-blind, randomized, placebo-controlled, multicenter trial of mesalamine for the prevention of recurrence of diverticulitis Gastroenterology 1 2013 S139
100. W. Kruis, V. Kardalinos, A. Curtin, and et al. Daily mesalamine fails to prevent recurrent diverticulitis in a large placebo controlled multicenter trial Gastroenterology 1 2014 S-187
101. F. Parente, S. Bargiggia, A. Prada, and et al. Intermittent treatment with mesalazine in the prevention of diverticulitis recurrence: A randomised multicentre pilot double-blind placebo-controlled study of 24-month duration Int J Colorectal Dis 28 2013 1423 1431
102. J.B. Raskin, M.A. Kamm, M.M. Jamal, and et al. Mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials Gastroenterology 147 2014 793 802
103. N. Stollman, S. Magowan, F. Shanahan, and et al. A randomized controlled study of mesalamine after acute diverticulitis: Results of the DIVA trial J Clin Gastroenterol 47 2013 621 629
104. H. Ye, M. Losada, and A.B. West Diverticulosis coli: update on a "Western" disease Adv Anat Pathol 12 2005 74 80
105. B.G. Feagan, and J.K. Macdonald Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis Cochrane Database Syst Rev 10 2012 CD000544
106. M.A. Ohlow, J.T. Fuhrmann, and B. Lauer Prevalence and spectrum of coronary artery anomalies in patients with an isolated congenital left ventricular aneurysm or diverticulum Clin Cardiol 34 2011 226 232
107. A. Lanas, J. Ponce, A. Bignamini, and et al. One year intermittent rifaximin plus fibre supplementation vs. fibre supplementation alone to prevent diverticulitis recurrence: a proof-of-concept study Dig Liver Dis 45 2013 104 109
108. A.B. West NDSG The pathology of diverticulitis J Clin Gastroenterol 42 2008 1137 1138
109. A. Colecchia, A. Vestito, F. Pasqui, and et al. Efficacy of long term cyclic administration of the poorly absorbed antibiotic rifaximin in symptomatic, uncomplicated colonic diverticular disease World J Gastroenterol 13 2007 264 269
110. G. Comparato, L. Fanigliulo, L. Cavallaro, and et al. Prevention of complications and symptomatic recurrences in diverticular disease with mesalazine: a 12-month follow-up Dig Dis Sci 52 2007 2934 2941
111. G. Latella, M. Pimpo, S. Sottili, and et al. Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon Int J Colorectal Dis 18 2003 55 62
112. C. Papi, A Ciaco, M. Koch, and et al. Efficacy of rifaximin on symptoms of uncomplicated diverticular disease of the colon. A pilot multicentre open trial. Diverticular Disease Study Group Ital J Gastroenterol 24 1992 452 456
113. C. Papi, A. Ciaco, M. Koch, and et al. Efficacy of rifaximin in the treatment of symptomatic diverticular disease of the colon. A multicentre double-blind placebo-controlled trial Aliment Pharmacol Ther 9 1995 33 39
114. A. Tursi, G. Brandimarte, G. Giorgetti, and et al. Balsalazide and/or high-potency probiotic mixture (VSL#3) in maintaining remission after attack of acute, uncomplicated diverticulitis of the colon Int J Colorectal Dis 22 2007 1103 1108
115. A. Tursi, G. Brandimarte, and R. Daffina Long-term treatment with mesalazine and rifaximin versus rifaximin alone for patients with recurrent attacks of acute diverticulitis of colon Dig Liver Dis 34 2002 510 515
116. L. Dughera, A.M. Serra, E. Battaglia, and et al. Acute recurrent diverticulitis is prevented by oral administration of a polybacterial lysate suspension Minerva Gastroenterol Dietol 50 2004 149 153
117. A. Tursi, G. Brandimarte, W. Elisei, and et al. Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease-a double-blind, randomised, placebo-controlled study Aliment Pharmacol Ther 38 2013 741 751
118. F. Shanahan The neglected spectrum of diverticular-related disorders Clin Gastroenterol Hepatol 11 2013 1620 1621
119. G.A. Preidis, and J. Versalovic Targeting the human microbiome with antibiotics, probiotics, and prebiotics: gastroenterology enters the metagenomics era Gastroenterology 136 2009 2015 2031
120. L.L. Strate, Y.L. Liu, W.H. Aldoori, and et al. Physical activity decreases diverticular complications Am J Gastroenterol 104 2009 1221 1230
121. H.P. Peters, W.R. De Vries, G.P. Vanberge-Henegouwen, and et al. Potential benefits and hazards of physical activity and exercise on the gastrointestinal tract Gut 48 2001 435 439
122. S.N. Sullivan The effect of running on the gastrointestinal tract J Clin Gastroenterol 6 1984 461 465
123. R.R. Pate, M. Pratt, S.N. Blair, and et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine JAMA 273 1995 402 407
124. P.T. Williams Incident diverticular disease is inversely related to vigorous physical activity Med Sci Sports Exerc 41 2009 1042 1047
125. M. Bianchi, V. Festa, A. Moretti, and et al. Meta-analysis: long-term therapy with rifaximin in the management of uncomplicated diverticular disease Aliment Pharmacol Ther 33 2011 902 910