Skip to main content
SpringerLink
Log in

Konservative Therapie, Primär- und Sekundärprophylaxe der Divertikelkrankheit

  • Chapter
Divertikulose und Divertikelkrankheit

  • 2801 Accesses

Zusammenfassung

Für die weitaus meisten Patienten mit einer unkomplizierten Divertikelkrankheit ist ein konservatives Vorgehen zu empfehlen. Dies gilt auch für Menschen mit einer Divertikulose des Kolons, die zukünftige Komplikationen vermeiden wollen. Hierbei steht eine große Spanne an Maßnahmen zur Verfügung, angefangen mit einer adäquaten Ernährungsberatung über Erläuterungen probaten Verhaltens mit Lifestyle-Modifikationen, der Meidung risikofördernder Medikamente bis hin zur Pharmakotherapie. Hierbei ist allerdings einzugestehen, dass das Armamentarium evidenzbasierter medikamentöser Einflussmöglichkeiten derzeit noch eingeschränkt ist.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Aldoori WH, Giovannucci EL, Rimm EB, et al. (1995a) A prospective study of alcohol, smoking, caffeine, and the risk of symptomatic diverticular disease in men. Ann Epidemiol 5: 221–228

    Google Scholar 

  • Aldoori WH, Giovannucci EL, Rimm EB, et al. (1995b) Prospective study of physical activity and the risk of symptomatic diverticular disease in men. Gut 36: 276–282

    Google Scholar 

  • Aldoori WH, Giovannucci EL, Rimm EB, et al. (1998a) Use of acetaminophen and nonsteroidal anti-inflammatory drugs: a prospective study and the risk of symptomatic diverticular disease in men. Arch Fam Med 7: 255–260

    Google Scholar 

  • Aldoori WH, Giovannucci EL, Rockett HR, et al. (1998b) A prospective study of dietary fiber types and symptomatic diverticular disease in men. J Nutr 128: 714–719

    Google Scholar 

  • Bianchi M, Festa V, Moretti A, et al. (2011) Meta-analysis: long-term therapy with rifaximin in the management of uncomplicated diverticular disease. Aliment Pharmacol Ther 33: 902–910

    Google Scholar 

  • Boynton W, Floch M (2013) New strategies for the management of diverticular disease: insights for the clinician. Therap Adv Gastroenterol 6: 205–213

    Google Scholar 

  • Brandimarte G, Tursi A (2004) Rifaximin plus mesalazine followed by mesalazine alone is highly effective in obtaining remission of symptomatic uncomplicated diverticular disease. Med Sci Monit 10: PI70–73

    Google Scholar 

  • Brodribb AJ (1977) Treatment of symptomatic diverticular disease with a high-fibre diet. Lancet 1: 664–666

    Google Scholar 

  • Brodribb AJ, Humphreys DM (1976) Diverticular disease: three studies. Part III – Metabolic effect of bran in patients with diverticular disease. Br Med J 1: 428–430

    Google Scholar 

  • Campbell K, Steele RJ (1991) Non-steroidal anti-inflammatory drugs and complicated diverticular disease: a case-control study. Br J Surg 78: 190–191

    Google Scholar 

  • Chabok A, Pahlman L, Hjern F, et al. (2012) Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg 99: 532–539

    Google Scholar 

  • Comparato G, Fanigliulo L, Cavallaro LG, et al. (2007) Prevention of complications and symptomatic recurrences in diverticular disease with mesalazine: a 12-month follow-up. Dig Dis Sci 52: 2934–2941

    Google Scholar 

  • Corder A (1987) Steroids, non-steroidal anti-inflammatory drugs, and serious septic complications of diverticular disease. Br Med J (Clin Res Ed) 295: 1238

    Google Scholar 

  • Crowe FL, Appleby PN, Allen NE, et al. (2011) Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ 343: d4131

    Google Scholar 

  • Daniels L, Unlu C, de Korte N, et al. (2017) Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg 104: 52–61

    Google Scholar 

  • de Korte N, Kuyvenhoven JP, van der Peet DL, et al. (2012) Mild colonic diverticulitis can be treated without antibiotics. A case-control study. Colorectal Dis 14: 325–330

    Google Scholar 

  • Di Mario F, Aragona G, Leandro G, et al. (2005) Efficacy of mesalazine in the treatment of symptomatic diverticular disease. Dig Dis Sci 50: 581–586

    Google Scholar 

  • Di Stefano M, Strocchi A, Malservisi S, et al. (2000) Non-absorbable antibiotics for managing intestinal gas production and gas-related symptoms. Aliment Pharmacol Ther 14: 1001–1008

    Google Scholar 

  • D’Inca R, Pomerri F, Vettorato MG, et al. (2007) Interaction between rifaximin and dietary fibre in patients with diverticular disease. Aliment Pharmacol Ther 25: 771–779

    Google Scholar 

  • Fric P, Zavoral M (2003) The effect of non-pathogenic Escherichia coli in symptomatic uncomplicated diverticular disease of the colon. Eur J Gastroenterol Hepatol 15: 313–315

    Google Scholar 

  • Furnari M, Parodi A, Gemignani L, et al. (2010) Clinical trial: the combination of rifaximin with partially hydrolysed guar gum is more effective than rifaximin alone in eradicating small intestinal bacterial overgrowth. Aliment Pharmacol Ther 32: 1000–1006

    Google Scholar 

  • Goh H, Bourne R (2002) Non-steroidal anti-inflammatory drugs and perforated diverticular disease: a case-control study. Ann R Coll Surg Engl 84: 93–96

    Google Scholar 

  • Hjern F, Josephson T, Altman D, et al. (2007) Conservative treatment of acute colonic diverticulitis: are antibiotics always mandatory? Scand J Gastroenterol 42: 41–47

    Google Scholar 

  • Hjern F, Wolk A, Hakansson N (2011) Smoking and the risk of diverticular disease in women. Br J Surg 98: 997–1002

    Google Scholar 

  • Hjern F, Wolk A, Hakansson N (2012) Obesity, physical inactivity, and colonic diverticular disease requiring hospitalization in women: a prospective cohort study. Am J Gastroenterol 107: 296–302

    Google Scholar 

  • Hodgson WJ (1977) The placebo effect. Is it important in diverticular disease? Am J Gastroenterol 67: 157–162

    Google Scholar 

  • Humes DJ, Fleming KM, Spiller RC, et al. (2011) Concurrent drug use and the risk of perforated colonic diverticular disease: a population-based case-control study. Gut 60: 219–224

    Google Scholar 

  • Hyland J, Taylor I (1980) Does a high fibre diet prevent the complications of diverticular disease? Br J Surg 67: 77–79

    Google Scholar 

  • Kruis W, Meier E, Schumacher M, et al. (2013) Randomised clinical trial: mesalazine (Salofalk granules) for uncomplicated diverticular disease of the colon – a placebo-controlled study. Aliment Pharmacol Ther 37: 680–690

    Google Scholar 

  • Kruis W, Kardalinos V, Curtin A, et al. (2014) Daily Mesalamine Fails to Prevent Recurrent Diverticulitis in a Large Placebo Controlled Multicenter Trial. Gastroenterology 146 (Suppl 1): 1099

    Google Scholar 

  • Langman MJ, Morgan L, Worrall A (1985) Use of anti-inflammatory drugs by patients admitted with small or large bowel perforations and haemorrhage. Br Med J (Clin Res Ed) 290: 347–349

    Google Scholar 

  • Latella G, Pimpo MT, Sottili S, et al. (2003) Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon. Int J Colorectal Dis 18: 55–62

    Google Scholar 

  • Leifeld L, Germer CT, Bohm S, et al. (2014) S2k guidelines diverticular disease/diverticulitis. Z Gastroenterol 52: 663–710

    Google Scholar 

  • Morris CR, Harvey IM, Stebbings WS, et al. (2003) Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease. Br J Surg 90: 1267–1272

    Google Scholar 

  • Ornstein MH, Littlewood ER, Baird IM, et al. (1981) Are fibre supplements really necessary in diverticular disease of the colon? Br Med J (Clin Res Ed) 282: 1629–1630

    Google Scholar 

  • Painter NS, Burkitt DP (1971) Diverticular disease of the colon: a deficiency disease of Western civilization. Br Med J 2: 450–454

    Google Scholar 

  • Painter NS, Almeida AZ, Colebourne KW (1972) Unprocessed bran in treatment of diverticular disease of the colon. Br Med J 2: 137–140

    Google Scholar 

  • Papi C, Ciaco A, Koch M, et al. (1995) Efficacy of rifaximin in the treatment of symptomatic diverticular disease of the colon. A multicentre double-blind placebo-controlled trial. Aliment Pharmacol Ther 9: 33–39

    Google Scholar 

  • Peery AF, Barrett PR, Park D, et al. (2012) A high-fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology 142: 266–272.e1

    Google Scholar 

  • Piekarek K, Israelsson LA (2008) Perforated colonic diverticular disease: the importance of NSAIDs, opioids, corticosteroids, and calcium channel blockers. Int J Colorectal Dis 23: 1193–1197

    Google Scholar 

  • Pimentel M, Lembo A, Chey WD, et al. (2011) Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med 364: 22–32

    Google Scholar 

  • Raskin JB, Kamm MA, Jamal MM, et al. (2014) Mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials. Gastroenterology 147: 793–802

    Google Scholar 

  • Rosemar A, Angeras U, Rosengren A (2008) Body mass index and diverticular disease: a 28-year follow-up study in men. Dis Colon Rectum 51: 450–455

    Google Scholar 

  • Smits BJ, Whitehead AM, Prescott P (1990) Lactulose in the treatment of symptomatic diverticular disease: a comparative study with high-fibre diet. Br J Clin Pract 44: 314–318

    Google Scholar 

  • Stollman N, Magowan S, Shanahan F, et al. (2013) A randomized controlled study of mesalamine after acute diverticulitis: results of the DIVA trial. J Clin Gastroenterol 47: 621–629

    Google Scholar 

  • Strate LL, Liu YL, Syngal S, et al. (2008) Nut, corn, and popcorn consumption and the incidence of diverticular disease. JAMA 300: 907–914

    Google Scholar 

  • Strate LL, Liu YL, Aldoori WH, et al. (2009) Physical activity decreases diverticular complications. Am J Gastroenterol 104: 1221–1230

    Google Scholar 

  • Strate LL, Liu YL, Huang ES, et al. (2011) Use of aspirin or nonsteroidal anti-inflammatory drugs increases risk for diverticulitis and diverticular bleeding. Gastroenterology 140: 1427–1433

    Google Scholar 

  • Taylor CJ, Layani L, Ghusn MA, et al. (2006) Perforated diverticulitis managed by laparoscopic lavage. ANZ J Surg 76: 962–965

    Google Scholar 

  • Trepsi E, Colla C, Panizza P, et al. (1999) Therapeutic and prophylactic role of mesalazine (5-ASA) in symptomatic diverticular disease of the large intestine. 4 year follow-up results. Minerva Gastroenterol Dietol 45: 245–252

    Google Scholar 

  • Tursi A, Brandimarte G, Daffina R (2002) Long-term treatment with mesalazine and rifaximin versus rifaximin alone for patients with recurrent attacks of acute diverticulitis of colon. Dig Liver Dis 34: 510–515

    Google Scholar 

  • Tursi A, Brandimarte G, Giorgetti GM, et al. (2006) Mesalazine and/or Lactobacillus casei in preventing recurrence of symptomatic uncomplicated diverticular disease of the colon: a prospective, randomized, open-label study. J Clin Gastroenterol 40: 312–316

    Google Scholar 

  • Tursi A, Brandimarte G, Giorgetti GM, et al. (2007) Continuous versus cyclic mesalazine therapy for patients affected by recurrent symptomatic uncomplicated diverticular disease of the colon. Dig Dis Sci 52: 671–674

    Google Scholar 

  • Tursi A, Brandimarte G, Giorgetti GM, et al. (2008) Mesalazine and/or Lactobacillus casei in maintaining long-term remission of symptomatic uncomplicated diverticular disease of the colon. Hepatogastroenterology 55: 916–920

    Google Scholar 

  • Wilson RG, Smith AN, Macintyre IM (1991) Non-steroidal anti-inflammatory drugs and complicated diverticular disease: a case-control study. Br J Surg 78: 1148

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medizinische Klinik III, Allgemeine Innere Medizin und Gastroenterologie St. Bernward Krankenhaus, Treibestraße 9, 31134, Hildesheim

    Prof. Dr. med. Ludger Leifeld

Authors
  1. Prof. Dr. med. Ludger Leifeld
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Universitätsklinikum Würzburg, Würzburg, Deutschland

    Christoph-Thomas Germer

  2. St. Bernward Krankenhaus, Hildesheim, Deutschland

    Ludger Leifeld

  3. Evangelisches Krankenhaus Kalk, Köln, Deutschland

    Wolfgang Kruis

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag GmbH Deutschland

About this chapter

Cite this chapter

Leifeld, L. (2018). Konservative Therapie, Primär- und Sekundärprophylaxe der Divertikelkrankheit. In: Germer, CT., Leifeld, L., Kruis, W. (eds) Divertikulose und Divertikelkrankheit. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53549-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-53549-3_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-53548-6

  • Online ISBN: 978-3-662-53549-3

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation