Delphi Consensus on Colonic Diverticular Disease

This is a comprehensive consensus statement on all aspects and types of diverticular disease of the colon. Thirty-two experts from 14 countries (mostly European) and multiple disciplines participated in a structured Delphi process to create consensus-based recommendations. The consensus report presents 46 statements that cover definitions, epidemiology and pathogenesis, clinical findings, diagnosis, medical treatment, and surgical treatment.

The report indicates there is generally good agreement among experts on managing most aspects of diverticular disease, even when much of the evidence is of moderate or lower quality.

Among the statements included in the paper are the following regarding symptomatic, uncomplicated diverticular disease (SUDD), for which there was no disagreement:

• SUDD is a clinical condition characterized by recurrent abdominal symptoms (eg, pain, discomfort, bloating, bowel habit changes) attributable to diverticula, in the absence of complications.
• In SUDD patients, a high-fiber diet or fiber supplementation may provide some clinical benefit.
• Certain probiotics may provide clinical benefit in patients with SUDD.
• Mesalamine may be effective in inducing and maintaining relief of symptoms, especially abdominal pain, in patients with SUDD.
• Rifaximin plus fiber may be effective in inducing and maintaining relief of symptoms in patients with SUDD.