Trivedi Chirag D, Das Kiron M
Division of Gastroenterology, Department of Medicine, Crohn's and Colitis Center of New Jersey, New Brunswick, NJ 08903, USA.
J Clin Gastroenterol. 2008 Nov-Dec;42(10):1145-51. doi: 10.1097/MCG.0b013e318188adc1.
Diverticular disease (DD) of the colon is common. This paper reviews the evidence supporting the role of some of the conventional medical therapies such as fiber and nonabsorbable antibiotics in the treatment of DD. More importantly, it will review the emerging body of evidence supporting the use of 5-aminosalicylic acid and probiotics for symptomatic or complicated DD. Possible mechanisms supporting the role of 5-aminosalicylates will also be discussed. On the basis of strength of the evidence supporting each medical intervention, recommendations will be graded in an evidence-based fashion. Finally, an evidence-based algorithmic approach is proposed for the medical management of DD. This paper does not discuss the use of absorbable antibiotics such as ciprofloxin and metronidazole, which are discussed in all standard textbooks. The purpose of this paper is to discuss newer recommendations.
结肠憩室病(DD)很常见。本文回顾了支持一些传统医学疗法(如纤维和不可吸收抗生素)在DD治疗中作用的证据。更重要的是,它将回顾支持使用5-氨基水杨酸和益生菌治疗有症状或复杂DD的新证据。还将讨论支持5-氨基水杨酸盐作用的可能机制。根据支持每种医学干预措施的证据强度,将以循证方式对建议进行分级。最后,提出了一种基于循证的算法方法用于DD的药物治疗。本文不讨论可吸收抗生素(如环丙沙星和甲硝唑)的使用,所有标准教科书中都有相关论述。本文的目的是讨论更新的建议。