Correspondence to Author: Antonio Costanzo MD, Valentina Rampulla MD, Antonio Varricchio MD, Maria Vittoria Mannucci, Martina Sala, Chiara Vescovi, Lorenzo Vescovi MD. 

Antonio Costanzo MD, General and Emergency Surgery, Asst Bergamo est Ospedale Bolognini di Seriate (BG), Italy. Email: antocosta987@gmail.com
Valentina Rampulla MD, General and Oncological Surgery Asst Bergamo Ovest Ospedale di Treviglio-Caravaggio (BG), Italy. Email: valentina6851@hotmail.com
Antonio Varricchio MD, AORN San Pio di Benevento (Bn), Italy. Email: an.varr89@hotmail.it
Maria Vittoria Mannucci, Post-Graduate School of General Surgery, Università degli Studi di Milano La Statale, Milan, Italy. Email: maria.mannucci@unimi.it
Martina Sala, Post-Graduate School of General Surgery, Università degli Studi di Milano La Statale, Milan, Italy. Email: martina.sala1@unimi.it
Chiara Vescovi, Medicine and Surgery School, Università degli Studi di Messina (Me), Italy. Email: chiara.vescovi98@gmail.com
Lorenzo Vescovi MD, General and Emergency Surgery, Asst Bergamo est Ospedale Bolognini di Seriate (BG), Italy. Email: lorenzo.vescovi@asst-bergamoest.it.

DOI: 10.52338/jjogastro.2025.5206

Abstract:

Acute colonic diverticulitis is a common gastrointestinal condition with increasing prevalence among younger populations and in developing countries adopting Western dietary habits. This narrative review explores current evidence and clinical practices surrounding the outpatient management of uncomplicated diverticulitis. Diagnosis relies on clinical evaluation and contrast-enhanced abdominal CT to distinguish between uncomplicated and complicated cases. Conservative treatment—centered on analgesia and dietary modifications— has been shown to be safe and effective, with antibiotics reserved for select patients with comorbidities or worsening symptoms. The role of adjunct therapies such as rifaximin, mesalazine, and probiotics remains uncertain. Surgical intervention should be individualized, based on clinical severity and imaging findings rather than episode count. This review supports a personalized, evidence-based approach to outpatient care, with the aim of reducing unnecessary hospitalizations and optimize long-term outcomes.

Keywords: Uncomplicated diverticulitis, Outpatient management, Selective antibiotic therapy, Clinical follow-up, Surgical indications

Citation:

Antonio Costanzo MD, Outpatient Management of Uncomplicated Acute Colonic Diverticulitis: A Narrative Review. Japanese Journal of Gastroenterology 2025.