Diverticulitis

Risk factors for diverticulosis include being older than 65 years, obesity (body mass index [BMI] of 30 or more), high blood pressure, type 2 diabetes, certain medications (such as opioids, steroids, and nonsteroidal anti-inflammatory drugs [NSAIDs]), connective tissue diseases (such as polycystic kidney disease, Marfan syndrome, and Ehlers-Danlos syndrome), and specific genetic variants.1

By age 60 years, nearly 60% of people have diverticulosis, most often on the left side of the colon. About 1% to 4% of people with diverticulosis develop diverticulitis in their lifetime. Acute diverticulitis affects about 180 per 100 000 people in the US each year, resulting in approximately 200 000 hospitalizations annually.

Author/s:

Shreya Narayanan, Christopher D. Jackson, MD

Diverticulitis in Older Adults: A Review of Etiology, Diagnosis, and Management

Alex Haga — Thu, 29 May 2025 13:09:15 +0000

Date Added:

May 29, 2025

Journal/Publication:

Journal of the American Geriatrics Society

Publication Date:

February 8, 2025

Issue:

Volume:

Pages:

1598-1607

URL:

Diverticulitis in Older Adults: A Review of Etiology, Diagnosis, and Management

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1111/jgs.19388

Keywords

Diverticulitis

surgical decision‐making

surgical outcomes

PMID (1):

39921851

MeSH

Diverticulitis

A review of the diagnosis and treatment of geriatric patients with diverticulitis. James W. Mold, MD, MPH

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Background: Diverticulitis accounts for over 300,000 hospitalizations annually in the United States and its incidence increases with age. Among older adults, diverticulitis is the fourth leading cause for emergency surgery. Older adults with multimorbidity and geriatric syndromes are often excluded from clinical studies, leaving a gap in the evidence needed to guide management. Here, we provide a clinically oriented review of the diagnosis and management of older adults with diverticulitis through the lens of age-friendly care.

Methods and results: We reviewed the literature describing the epidemiology, diagnosis, management, and prevention of diverticulitis in older adults. Due to age-related physiologic changes, the presence of geriatric syndromes, and multimorbidity, older adults with diverticulitis often present with atypical symptoms, variable laboratory findings, and are at higher risk for complications than younger patients. Guidelines support a more aggressive approach to diagnosis in this population, with lower threshold for obtaining diagnostic imaging. Antibiotics remain a mainstay of treatment for uncomplicated disease, and surgical management should be focused on severity of disease and the balance between the likelihood of improving quality of life and risks and burden of treatment.

Conclusions: Diverticulitis is a common disease that has a unique presentation among older individuals with limited evidence to guide management. Diagnosis and treatment should focus on what matters most to the patient, providing the most meaningful outcome possible within the context of multimorbidity, patient goals, symptom burden, and anticipated treatment outcomes.

Author/s:

Jessica K Hall, Mark A Supiano, Jessica N Cohan

Antibiotics for acute diverticulitis

Erin Blanchette — Wed, 02 Apr 2025 21:42:20 +0000

Date Added:

April 2, 2025

Journal/Publication:

Canadian Family Physician

Publisher:

College of Family Physicians of Canada

Publication Date:

March 1, 2025

Issue:

Volume:

Pages:

184

URL:

Antibiotics for acute diverticulitis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.46747/cfp.7103184

Keywords

PMID (1):

40102007

MeSH

Diverticulitis

anti-bacterial agents

Frail Elderly

Colorectal Neoplasms

A concise summary of the evidence regarding treatment of acute diverticulitis with antibiotics. James W. Mold, MD, MPH

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Clinical question: Do antibiotics change clinical outcomes for patients with acute uncomplicated diverticulitis?
Bottom line: For nonseptic immunocompetent patients with acute uncomplicated diverticulitis, antibiotics do not alter early complication or recurrence rates.

Author/s:

Michael R Kolber, Clarence K Wong