Management of Diverticular Disease

Suzanne Albrecht, PharmD, MSLIS

Disclosures

US Pharmacist 

In This Article

Other Treatments

Probiotics

Probiotics are "good" bacteria that are ingested orally and affect the intestinal microbial flora. The three ways in which they are beneficial are: 1) they colonize the gut, which in turn inhibits the growth of "bad" bacteria; 2) they modulate the immune function of the host; and 3) they improve the intestinal epithelial layer, thus improving its barrier function and discouraging the transmigration of bacteria. Since there may be an alteration of the intestinal flora in and around diverticula that can result in chronic inflammation, the concept of using probiotics for the prevention of diverticulitis seems plausible. By discouraging the growth of pathogenic microbes in the diverticula and the adjacent area, as well as boosting immune function, probiotics may play a beneficial role in tempering the inflammation associated with diverticulitis. There are limited data supporting this theory, however, and more studies need to be done in order to solidify this presumption.[12]

Anti-inflammatories

Anti-inflammatory drugs, 5-aminosalicylic acid (5-ASA) medications in particular, may be of benefit to patients with chronic low-level diverticular symptoms.[3] There is strong evidence that mesalamine taken with rifamixin (a nonabsorbable antibiotic) improves the severity of symptoms of patients with diverticular disease. It also prevents recurrence of diverticulitis episodes in patients with complicated diverticulitis.[11]

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