Background: The aim of this study was to assess the long-term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT-verified left-sided acute uncomplicated diverticulitis to management without or with antibiotics.
Methods: The medical records of patients who had participated in the AVOD trial were reviewed for long-term results such as recurrences, complications and surgery. Quality-of-life questionnaires (EQ-5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes.
Results: A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no-antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5·0 per cent; P = 0·737), surgery for diverticulitis (6·2 versus 7·1 per cent; P = 0·719) or colorectal cancer (0·4 versus 2·1 per cent; P = 0·061). The response rate for the EQ-5D™ was 52·8 versus 45·2 per cent respectively (P = 0·030), and no differences were found between the two groups in any of the measured dimensions.
Conclusion: Antibiotic avoidance for uncomplicated diverticulitis is safe in the long term.
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http://dx.doi.org/10.1002/bjs.11239 | DOI Listing |
Biosci Microbiota Food Health
September 2024
Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
Why patients with symptomatic uncomplicated diverticular disease (SUDD) may develop acute diverticulitis (AD) is still unknown. We analyzed the gut microbiota (GM) in two SUDD patients, one who did experience SUDD recurrence but not AD occurrence (case 1) and one who did experience AD occurrence during follow-up (case 2). The GM of these patients showed differences in terms of phyla (Firmicutes and Bacteroidota in case 1; Actinobacteriota and Proteobacteria in case 2) and subgenera ( and in case 1 and , , , , group, and in case 2).
View Article and Find Full Text PDFTherap Adv Gastroenterol
January 2025
Department of Surgery, Odense University Hospital, Odense, Denmark.
Background: Little is known about the involvement of gut microbiota in the disease course of diverticulitis and the potential benefits of manipulating the gut milieu. We propose to conduct a randomised placebo-controlled feasibility trial of faecal microbiota transplantation (FMT) given as capsules to patients with acute uncomplicated diverticulitis.
Objectives: The objective is primarily to investigate the feasibility of clinical safety, explore efficacy associated with FMT in this patient population, and examine changes in patient-reported quality of life and the composition and function of the gut microbiota.
Genome Med
December 2024
Department of Medical and Surgical Sciences, Digestive Diseases Centre (CEMAD), Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy.
Diverticular disease (DD) is widespread worldwide. The role of gut microbiota (GM) in DD is not entirely understood. Here we discuss the significance of the current knowledge on GM in the different stages of DD and how crucial these acquisitions are for designing diagnostic and therapeutic trials in this field.
View Article and Find Full Text PDFDis Colon Rectum
December 2024
Department of Surgery, McGill University, Montreal, Quebec, Canada.
Background: Non-antibiotic outpatient treatment of acute uncomplicated diverticulitis is safe; however, uptake remains low.
Objective: To assess the success of non-antibiotic management of uncomplicated diverticulitis through a nurse clinician-led outpatient program.
Design: Retrospective audit from June 2022-March 2024.
Expert Rev Gastroenterol Hepatol
November 2024
Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Introduction: Diverticular disease, including diverticulosis and diverticulitis, presents a significant health concern globally, with increasing prevalence in Western societies and emerging trends in Asia. The incidence of diverticulitis, is on the rise, leading to significant morbidity and healthcare costs.
Areas Covered: A literature search was conducted using the PubMed database, and studies published between 1995 and 2024 were selected based on their relevance to the overall understanding of disease.
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