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Small bowel diverticulosis: An overlooked entity

Current Treatment Options in Gastroenterology volume 6, pages 3–11 (2003)Cite this article

Opinion statement

Small bowel diverticulosis (SBD) is a rare entity. Most cases of diverticulosis are asymptomatic. SBD is often discovered incidentally during contrast studies and endoscopy. When patients report chronic gastrointestinal symptoms such as abdominal pain, bloating, flatulence, and anemia, SBD is often an overlooked diagnosis. Patients requiring treatment for SBD are those with complications such as malabsorption, hemorrhage, obstruction, and acute inflammation with abscess or rarely perforation. Malabsorption can be managed with broad-spectrum antibiotics and vitamin supplementation. Hemorrhage is treated conservatively with resuscitation efforts, but recurrent bleeding requires surgery. Enteroliths causing obstruction in the duodenum can be relieved by endoscopy, that is, by manipulation, but jejunoileal obstruction requires a resection. Pseudoobstruction may be managed with prokinetics such as metoclopramide, erythromycin, and the 5-hydroxytryptamine 4 agonist tegaserod. Uncomplicated cases of SBD are treated with bowel rest and antibiotics. However, perforation or abscess formation not amenable to percutaneous drainage mandates surgical resection. Any patient with a triad of anemia, abdominal pain, and an abdominal radiograph with dilated loops of small bowel merits SBD in the differential diagnosis.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, North Shore University Hospital-New York University School of Medicine, 300 Community Drive, 11030, Manhasset, NY, USA

    Seth A. Gross MD & Seymour Katz MD

Authors
  1. Seth A. Gross MD
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  2. Seymour Katz MD
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Gross, S.A., Katz, S. Small bowel diverticulosis: An overlooked entity. Curr Treat Options Gastro 6, 3–11 (2003). https://doi.org/10.1007/s11938-003-0027-4

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  • DOI: https://doi.org/10.1007/s11938-003-0027-4

Keywords

  • Diverticulitis
  • Diverticular Disease
  • Main Side Effect
  • Main Drug Interaction
  • Tegaserod