ABSTRACT
Diverticular disease of the colon is extremely common in developed countries and results in a significant health burden. Two decades ago, diverticulosis affected 30 million people in the United States, resulted in 200,000 hospitalizations, and cost over $30 million annually (1). Because the prevalence of diverticulosis increases with age, we will likely see a continued rise in societal impact from this condition as the population ages. Despite the morbidity observed in patients with symptomatic diverticular disease, the majority (80%) of patients with diverticulosis will remain entirely asymptomatic. This fact makes the pathogenesis and natural history of diverticular disease somewhat difficult to study. Some authors even question whether asymptomatic diverticulosis is, in fact, a ‘‘disease’’ at all. Nevertheless, important advances have been made in our understanding of diverticular disease and in the approach to treatment in the last few decades. In this chapter, we review the incidence, pathophysiology, clinical presentation, and treatment of diverticular disease of the colon. Particular emphasis will be placed on the role of colonoscopy in the diagnosis and management of diverticular disease and on the emerging role of minimally invasive surgical management of diverticular complications.
