Rinas U, Adamek H E
Medizinische Klinik 2, Klinikum Leverkusen.
MMW Fortschr Med. 2006 Jul 20;148(29-30):37-41; quiz 42.
Over the last 100 years, the prevalence and incidence of diverticulosis and diverticular disease have increased dramatically in western industrialized countries. The main reasons for this are considered to be changes in eating habits, and the increasing age of the population. Conservative treatment of diverticulitis is an initial period of fasting and antibiotic treatment. For recurrence prevention, a fiber-rich diet is recommended. Studies providing evidence in support of the general recommendation of recurrence prophylaxis with poorly absorbed antibiotics, mesalazine or probiotics are to date not adequate. Elective prophylactic sigmoid resection is to be recommended following an episode of diverticulitis with complications, and after an episode of uncomplicated diverticulitis in long-term immunosuppressed patients who have already had an attack. Elective sigmoid resection after a healed second attack of uncomplicated diverticulitis is controversial.
在过去100年里,西方国家工业化国家中憩室病和憩室炎的患病率和发病率急剧上升。主要原因被认为是饮食习惯的改变以及人口老龄化。憩室炎的保守治疗是初期禁食和抗生素治疗。为预防复发,建议采用富含纤维的饮食。目前,尚无充分的研究证据支持使用吸收不良的抗生素、美沙拉嗪或益生菌进行复发预防的一般建议。对于伴有并发症的憩室炎发作后,以及长期免疫抑制且已发作过一次的患者发生无并发症的憩室炎发作后,建议进行择期预防性乙状结肠切除术。无并发症的憩室炎第二次发作愈合后进行择期乙状结肠切除术存在争议。