Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis

Publication Date: January 17, 2022
Last Updated: March 14, 2022

Summary of Recommendations

Recommendation 1

ACP suggests that clinicians refer patients for a colonoscopy after an initial episode of complicated left-sided colonic diverticulitis in patients who have not had recent colonoscopy. (C, L)
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Recommendation 2

ACP recommends against clinicians using mesalamine to prevent recurrent diverticulitis. (S, H)
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Recommendation 3

ACP suggests that clinicians discuss elective surgery to prevent recurrent diverticulitis after initial treatment in patients who have either uncomplicated diverticulitis that is persistent or recurs frequently or complicated diverticulitis. (C, L)
The informed decision whether or not to undergo surgery should be personalized based on a discussion of potential benefits, harms, costs, and patient's preferences.
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Recommendation Grading

Overview

Title

Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis

Authoring Organization

American College of Physicians

Publication Month/Year

January 17, 2022

Last Updated Month/Year

April 1, 2024

Supplemental Implementation Tools

Document Type

Guideline

Country of Publication

US

Document Objectives

The American College of Physicians (ACP) developed this guideline to provide clinical recommendations on the role of colonoscopy for diagnostic evaluation of colorectal cancer (CRC) after a presumed diagnosis of acute left-sided colonic diverticulitis and on the role of pharmacologic, nonpharmacologic, and elective surgical interventions to prevent recurrence after initial treatment of acute complicated and uncomplicated left-sided colonic diverticulitis. This guideline is based on the current best available evidence about benefits and harms, taken in the context of costs and patient values and preferences.

Target Patient Population

Adults with recent episodes of acute left-sided colonic diverticulitis

Target Provider Population

The target provider audience is all clinicians

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Assessment and screening

Diseases/Conditions (MeSH)

D003113 - Colonoscopy, D004238 - Diverticulitis, D004239 - Diverticulitis, Colonic

Keywords

colonoscopy, diverticulitis, Colon Diverticulosis

Source Citation

Qaseem A, Etxeandia-Ikobaltzeta I, Lin JS, Fitterman N, Shamliyan T, Wilt TJ; Clinical Guidelines Committee of the American College of Physicians*. Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians. Ann Intern Med. 2022 Jan 18. doi: 10.7326/M21-2711. Epub ahead of print. PMID: 35038270.

Supplemental Methodology Resources

Systematic Review Document, Data Supplement