Papi C, Camarri E
Servizio Gastroenterologia, Ospedale S. Filippo Neri, Roma, Italy.
Ital J Gastroenterol. 1992 Nov-Dec;24(9 Suppl 2):19-22.
Diverticular disease of the colon is a common health problem in western societies. Most patients with colonic diverticula are asymptomatic; it has been estimated that only 20% of individuals harboring diverticula will develop symptoms and signs of illness and a minority will develop major complications. Medical treatment of diverticular disease is aimed to the relief of symptoms and to prevent inflammatory complications. High fiber diets and antispasmodics are widely used in the treatment of uncomplicated diverticular disease although their real efficacy has not been fully elucidated. Antibiotics are used to treat major inflammatory complications of diverticular disease but apparently there is no rationale for their use in uncomplicated disease where an inflammatory component is, by definition, excluded. However two recent papers suggest a possible role of rifaximin, a broad-spectrum poorly absorbable antibiotic, in the management of mild acute diverticulitis and in obtaining symptomatic relief in patients with uncomplicated disease. Prospective studies with an adequate sample size per group of treatment are needed to assess the efficacy of cyclic long term administration of poorly absorbable antibiotics in preventing major complications of diverticular disease.
结肠憩室病在西方社会是一个常见的健康问题。大多数患有结肠憩室的患者没有症状；据估计，只有20%有憩室的个体才会出现疾病的症状和体征，少数人会发生严重并发症。憩室病的药物治疗旨在缓解症状并预防炎症并发症。高纤维饮食和抗痉挛药物广泛用于治疗非复杂性憩室病，尽管它们的实际疗效尚未完全阐明。抗生素用于治疗憩室病的严重炎症并发症，但显然在非复杂性疾病中使用抗生素没有依据，因为根据定义，非复杂性疾病不包括炎症成分。然而，最近的两篇论文表明，利福昔明（一种吸收性差的广谱抗生素）在轻度急性憩室炎的治疗以及非复杂性疾病患者的症状缓解方面可能发挥作用。需要进行每组治疗有足够样本量的前瞻性研究，以评估长期周期性服用吸收性差的抗生素预防憩室病严重并发症的疗效。
