Management
AGA Recommendations for the Management of Acute
Diverticulitis
Recommendation
Strength of
recommendation
Quality of
evidence
e AGA suggests that antibiotics should be used
selectively, rather than routinely, in patients with
acute uncomplicated diverticulitis.
Conditional Low
e AGA suggests that colonoscopy be
performed aer resolution of acute diverticulitis
in appropriate candidates to exclude the
misdiagnosis of a colonic neoplasm if a high-
quality examination of the colon has not been
recently performed.
Conditional Low
e AGA suggests against elective colonic
resection in patients with an initial episode of
acute uncomplicated diverticulitis. e decision
to perform elective prophylactic colonic resection
in this setting should be individualized.
Conditional Very Low
e AGA suggests a fiber-rich diet or fiber
supplementation in patients with a history of
acute diverticulitis.
Conditional Very Low
e AGA suggests against routinely advising
patients with a history of diverticulitis to avoid
consumption of seeds, nuts, and popcorn.
Conditional Very Low
e AGA suggests against routinely advising
patients with a history of diverticulitis to avoid
the use of aspirin.
Conditional Low
e AGA suggests advising patients with a
history of diverticulitis to avoid the use of
nonaspirin NSAIDs if possible.
Conditional Very Low
e AGA recommends against the use
of mesalamine aer acute uncomplicated
diverticulitis.
Strong Moderate
e AGA suggests against the use of rifaximin
aer acute uncomplicated diverticulitis.
Conditional Very Low
e AGA suggests against the use of probiotics
aer acute uncomplicated diverticulitis.
Conditional Very Low
e AGA suggests advising patients with
diverticular disease to consider vigorous physical
activity.
Conditional Very Low
