Shared Decision-Making in Diverticulitis

Abstract The management of diverticulitis has evolved significantly, shifting away from a rigid recommendation for colectomy after a specific number of episodes toward a more individualized, patient-centered approach. Evidence demonstrates that observation for recurrent uncomplicated diverticulitis does not substantially increase the risk of complications, emergency surgery, or mortality, challenging prior paradigms and supporting a focus on improving quality of life. As such, current guidelines advocate for shared decision-making that incorporates patient preferences, symptom burden, and surgical risk. The decision to pursue colectomy remains highly preference-sensitive and must balance clinical evidence with individual values and goals. Despite the importance of shared decision-making in this clinical context, decisional conflict and decision regret remain prevalent, reflecting ongoing challenges in aligning care with patient expectations. Future efforts should prioritize the integration of shared decision-making into clinical workflows through decision support tools, individualized risk models, and enhanced clinician training to improve patient-centered outcomes and quality of care in diverticulitis.