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Medical Management of “Uncomplicated” Colonic Diverticular Disease: A Review on Poorly Absorbed Antibiotics

Virginia Festa, Marco Bianchi, Angelo Dezi, Roberto Luchetti and Maurizio Koch

Diverticular disease of the colon is a common gastrointestinal disease. Although most patients remain asymptomatic for their whole life, about 20%-25% present symptoms related to “diverticular disease”. Current guidelines recommend only the use of high spectrum antibiotics in the initial treatment of acute diverticulitis. Several randomized trials suggest a role for a poorly absorbed antibiotic, such as rifaximin, in soothing symptoms and preventing complications such as diverticulitis. This review will highlight the role of long term administration of rifaximin in the treatment of symptomatic uncomplicated diverticular disease. The evidence suggests that rifaximin is effective for obtaining symptomatic relief and shows a positive trend in preventing complications.