A potential alternative treatment of uncomplicated painful diverticular disease by trans-colonoscopic irrigation technique: a preliminary report.

BACKGROUND: Colonic diverticular disease is a common disorder in elder patients. Medical treatment was usually recommended as the first line management for this disease. However, the recurrence rate of such disorder is still high. In patients with severe complications such as abscess or fulminant inflammation, non-invasive diagnostic examination, abdominal CT scan for example, is recommended. Its most common symptom is repeated abdominal pain with disturbance of bowel habit. Many patients are found to be with diverticular disease only after colonoscopic examination. The aim of this study is to introduce a new irrigation-draining method and to evaluate its efficacy in treatment of uncomplicated painful colonic diverticular disease.

METHODS: To reduce the risk of recurrence of acute diverticulitis and other severe complications, we introduce a transcolonoscopic irrigation technique for patients of uncomplicated diverticular disease by flushing out the obstructed fecalith from the diverticular sac in order to improve the drainage from the obstructed diverticular sac.

RESULTS: Thirty-two patients of uncomplicated painful diverticular disease with obstructed fecalith impacted were treated by this technique. Clinical symptom improved in all of them and no complications developed during the mean follow-up period of 46 months.

CONCLUSION: The results of this preliminary study suggest that this technique accomplished in the colonoscopic examination without additional therapeutic procedures. It provides another potential alternative to the conventional medical treatment for patients with uncomplicated diverticular disease.