Diverticulosis
Description General Measures Medicine Treatment Referral ICD-10 code: K57.0-5/K57.8-9 DESCRIPTION Colonic diverticulosis becomes increasingly common with age. Acute diverticulitis is suspected in patients with lower abdominal pain (typically in the left lower quadrant). The pain is usually constant and is often present for several days prior to presentation. Nausea and vomiting are often present
ICD-10 code: K57.0-5/K57.8-9
DESCRIPTION
Colonic diverticulosis becomes increasingly common with age. Acute diverticulitis is suspected in patients with lower abdominal pain (typically in the left lower quadrant). The pain is usually constant and is often present for several days prior to presentation. Nausea and vomiting are often present due to a bowel obstruction or an ileus as a result of peritoneal irritation. This may be associated with changes in bowel habits.
Diverticulosis can be complicated by haemorrhage or diverticulitis. Acute diverticulitis is inflammation of diverticulae and may, uncommonly, be accompanied by polymicrobial infection. Acute diverticulitis is defined as complicated in the presence of bowel obstruction, abscess, fistula, or perforation.
GENERAL MEASURES
Increase dietary fibre intake.
MEDICINE TREATMENT
Not all patients require antibiotics. If antibiotic treatment is required, the total duration is ten days depending on clinical response.
Uncomplicated diverticulitis:
- Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.
If unable to tolerate oral therapy:
- Amoxicillin/clavulanic acid, IV, 1.2 g 8 hourly.
- Switch to oral therapy once able to tolerate.
REFERRAL
- Acute diverticulitis with clinical deterioration or failure to improve on medical therapy.
- Peritonitis.
- Complicated diverticulitis (to a centre which can perform colonic surgery).
- Massive haemorrhage.
Click here for the NEMLC Recommendations for medicine amendments (2020-4 review cycle).
Standard Treatment Guidelines And Essential Medicines List For South Africa, Adult Hospital level, 2020-4_Version 1_July 2024
Chapter 1: Alimentary tract; 1.1 Gastrointestinal Disorders; 1.1.2 Diverticulosis
Drugs mentioned
ICD-10 codes
- K57.0Diverticular disease of small intestine with perforation and abscess
- K57.1Diverticular disease of small intestine without perforation or abscess
- K57.2Diverticular disease of large intestine with perforation and abscess
- K57.3Diverticular disease of large intestine without perforation or abscess
- K57.4Diverticular disease of both small and large intestine with perforation and abscess
- K57.5Diverticular disease of both small and large intestine without perforation or abscess
- K57.8Diverticular disease of intestine, part unspecified, with perforation and abscess
- K57.9Diverticular disease of intestine, part unspecified, without perforation or abscess