Diagnosis and management of diverticular disease of the colon – the Florence consensus report

Diverticulosis of the colon is the most frequent anatomical alteration of the colon in the developed countries, and its prevalence is rapidly increasing also in other parts of the World. About 20-25% of people having diverticulosis may develop symptoms, the so-called “diverticular disease”. This in principle leads to the recommendation that all patients having “diverticular disease” should receive treatment. In the context of the wide clinical spectrum associated with diverticulosis of the colon, specific issues persist and require regular updates for optimised management. The identification of distinct clinical scenarios, proper diagnostic tests and adoption of effective strategies for the treatment of symptoms and prevention of complications are addressed. The management of diverticular disease is challenged by the continuously rising prevalence of colonic diverticulosis worldwide, and new findings concerning its pathogenesis. This document considers the role of some predictive clinical and endoscopic characteristics . Thirty-one experts from 14 countries representing a global community, examined the current data related to diverticulosis and diverticular disease in five working groups: (1) epidemiology and pathogenesis, (2) clinical findings (3) diagnosis, (4) medical treatment and (5) surgical treatment. The results of the individual working groups were presented for a final consensus voting that included all participants. Recommendations are provided on the basis of the best available evidence and relevance to the management diverticulosis and diverticular disease in various clinical fields.