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Diverticular disease in the primary care setting

Lookup NU author(s): Emeritus Professor Amritpal Hungin

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Abstract

Diverticular disease is a chronic and common condition, and yet the impact of diverticular disease in primary care is largely unknown. The diagnosis of diverticular disease relies on the demonstration of diverticula in the colon, and the necessary investigations are often not available in primary care. The specificity and sensitivity of symptoms, clinical signs and laboratory tests alone are generally low and consequently the diagnostic process will be characterized by uncertainty. Also, the criteria for symptomatic uncomplicated diverticular disease in the absence of macroscopic inflammation are not clearly defined. Therefore both the prevalence of diverticular disease and the incidence of diverticulitis in primary care are unknown. Current recommendations for treatment and follow-up of patients with acute diverticulitis are based on studies where the diagnosis has been verified by computerized tomography. The results cannot be directly transferred to primary care where the diagnosis has to rely on the interpretation of symptoms and signs. Therefore, one must allow for greater diagnostic uncertainty, and safety netting in the event of unexpected development of the condition is an important aspect of the management of diverticulitis in primary care. The highest prevalence of diverticular disease is found among older patients, where multimorbidity and polypharmacy is common. The challenge is to remember the possible contribution of diverticular disease to the patient's overall condition and to foresee its implications in terms of advice and treatment in relation to other diseases.


Publication metadata

Author(s): Wensaas K-A, Hungin AP

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: 2nd International Symposium on Diverticular Disease of the Colon

Year of Conference: 2016

Pages: S86-S88

Print publication date: 01/10/2016

Acceptance date: 01/01/1900

ISSN: 0192-0790

Publisher: Lippincott Williams and Wilkins

URL: https://doi.org/10.1097/MCG.0000000000000596

DOI: 10.1097/MCG.0000000000000596

Series Title: Journal of Clinical Gastroenterology


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