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Cureus Aug 2023Diverticular disease is a common surgical condition, especially in the Western world. Its existence is well known in Asian countries as well; however, its impact on... (Review)
Review
Diverticular disease is a common surgical condition, especially in the Western world. Its existence is well known in Asian countries as well; however, its impact on Asian health care is not the same as that in Western countries. Diverticular disease has a variable presentation, and its implications can be challenging to manage both for the patient and the medical professionals. Diet and lifestyle are commonly associated with its etiology. In Western countries, much attention is given to diverticular disease, and with the acceptance of colonoscopy as a surveillance investigation, a greater number of people are diagnosed with diverticular disease at an early stage and overall. In acute presentations, a CT scan of the abdomen remains the investigation of choice. The most common presentation of diverticular disease is pain in the abdomen or a change in bowel habits. In most cases, diverticular disease is treated with medical intervention; however, in cases associated with severe complications or advanced stages, surgical modality remains the primary treatment.
PubMed: 37565180
DOI: 10.7759/cureus.43158 -
Frontiers in Cellular and Infection... 2023Digestive system diseases have evolved into a growing global burden without sufficient therapeutic measures. () is considered as a new potential economical therapy for... (Review)
Review
OBJECTIVES
Digestive system diseases have evolved into a growing global burden without sufficient therapeutic measures. () is considered as a new potential economical therapy for its probiotic effects in the gastrointestinal system. We have provided an overview of the researches supporting various strains' application in treating common digestive system diseases, including infantile colic, diarrhea, constipation, functional abdominal pain, infection, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases.
METHODS
The summarized literature in this review was derived from databases including PubMed, Web of Science, and Google Scholar.
RESULTS
The therapeutic effects of in digestive system diseases may depend on various direct and indirect mechanisms, including metabolite production as well as modulation of the intestinal microbiome, preservation of the gut barrier function, and regulation of the host immune system. These actions are largely strain-specific and depend on the activation or inhibition of various certain signal pathways. It is well evidenced that can be effective both as a prophylactic measure and as a preferred therapy for infantile colic, and it can also be recommended as an adjuvant strategy to diarrhea, constipation, infection in therapeutic settings. While preclinical studies have shown the probiotic potential of in the management of functional abdominal pain, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases, its application in these disease settings still needs further study.
CONCLUSION
This review focuses on the probiotic effects of on gut homeostasis via certain signaling pathways, and emphasizes the importance of these probiotics as a prospective treatment against several digestive system diseases.
Topics: Humans; Limosilactobacillus reuteri; Colic; Helicobacter Infections; Helicobacter pylori; Digestive System Diseases; Constipation; Abdominal Pain; Diarrhea; Diverticulitis; Inflammatory Bowel Diseases; Colorectal Neoplasms
PubMed: 37662007
DOI: 10.3389/fcimb.2023.1254198 -
Annals of Internal Medicine Mar 2024Acute colonic diverticulitis is a gastrointestinal condition that is frequently encountered by primary care and emergency department practitioners, hospitalists,... (Review)
Review
Acute colonic diverticulitis is a gastrointestinal condition that is frequently encountered by primary care and emergency department practitioners, hospitalists, surgeons, and gastroenterologists. Clinical presentation ranges from mild abdominal pain to peritonitis with sepsis. It is often diagnosed on the basis of clinical features alone, but imaging is necessary in more severe presentations to rule out such complications as abscess and perforation. Treatment depends on the severity of the presentation, the presence of complications, and underlying comorbid conditions. Medical and surgical treatment algorithms are evolving. This article provides an evidence-based, clinically relevant overview of the epidemiology, diagnosis, and treatment of acute diverticulitis.
Topics: Humans; Diverticulitis, Colonic; Diverticulitis; Tomography, X-Ray Computed; Peritonitis; Abdominal Pain; Acute Disease
PubMed: 38466995
DOI: 10.7326/AITC202403190 -
ACG Case Reports Journal May 2024Colonoscopy, generally safe but not devoid of risks, can lead to rare complications. We present 2 cases of postcolonoscopy diverticulitis (PCD). Case 1 was a 63-year-old...
Colonoscopy, generally safe but not devoid of risks, can lead to rare complications. We present 2 cases of postcolonoscopy diverticulitis (PCD). Case 1 was a 63-year-old woman, following colonoscopy, who developed acute sigmoid diverticulitis, despite a Diverticular Inflammation and Complication Assessment (DICA) score of 2, indicating extensive diverticulosis without inflammation. Conservative management with antibiotics led to recovery. Remarkably, she experienced a recurrent episode. Case 2 was a 74-year-old woman who had 2 colonoscopies, revealing pancolonic diverticulosis (DICA score: 2) without inflammation. After the second procedure, she developed severe sigmoid diverticulitis, managed conservatively with antibiotics. Discussion highlights PCD's rarity (prevalence: 0.04%-0.08%) and unclear pathogenesis. Both cases had DICA scores ≥2, suggesting a potential risk factor. Clinicians should recognize PCD, as it can mimic more common postcolonoscopy complications. Early recognition and management are vital.
PubMed: 38737096
DOI: 10.14309/crj.0000000000001362 -
Primary Care Sep 2023Benign conditions of the colon and rectum are a heterogeneous group of conditions that range from inflammatory to infectious to pelvic floor health conditions that... (Review)
Review
Benign conditions of the colon and rectum are a heterogeneous group of conditions that range from inflammatory to infectious to pelvic floor health conditions that affect large segments of the US population. These conditions include diverticular disease, hemorrhoids, and anorectal lesions. The initial presentation of these very common conditions often occurs in the outpatient primary care setting, and most can be managed by the primary care clinician. This article will provide an overview on the prevalence, diagnosis, and management of some of the most common benign colorectal disorders; these are broadly divided into diverticular disease, hemorrhoids, and anorectal conditions.
Topics: Humans; Hemorrhoids; Fissure in Ano; Diverticular Diseases; Ambulatory Care; Colorectal Neoplasms
PubMed: 37516514
DOI: 10.1016/j.pop.2023.03.011 -
JAMA Surgery Jun 2024Care of patients with diverticulitis is undergoing a paradigm shift. This narrative review summarizes the current evidence for left-sided uncomplicated and complicated... (Review)
Review
IMPORTANCE
Care of patients with diverticulitis is undergoing a paradigm shift. This narrative review summarizes the current evidence for left-sided uncomplicated and complicated diverticulitis. The latest pathophysiology, advances in diagnosis, and prevention strategies are also reviewed.
OBSERVATIONS
Treatment is moving to the outpatient setting, physicians are forgoing antibiotics for uncomplicated disease, and the decision for elective surgery for diverticulitis has become preference sensitive. Furthermore, the most current data guiding surgical management of diverticulitis include the adoption of new minimally invasive and robot-assisted techniques.
CONCLUSIONS AND RELEVANCE
This review provides an updated summary of the best practices in the management of diverticulitis to guide colorectal and general surgeons in their treatment of patients with this common disease.
Topics: Humans; Diverticulitis; Diverticulitis, Colonic; Anti-Bacterial Agents; Elective Surgical Procedures; Robotic Surgical Procedures
PubMed: 38630452
DOI: 10.1001/jamasurg.2023.8104