Samenvatting van de NHG-standaard ‘Diverticulitis’

Conflict of interests: N.J. de Wit received research funding from the Netherlands Organization for Health Research and Development (ZonMW). Financial support: none reported.

• The NHG practice guideline on ‘Diverticulitis’ provides general practitioners with directions on the diagnosis and treatment of uncomplicated and complicated diverticulitis.

• Diverticulitis is primarily a clinical diagnosis which can be supported by assessment of CRP.

• Uncomplicated diverticulitis is strongly suspected if the patient reports the development of persistent sharp, stabbing pain in the lower left abdomen within a couple of days; if there is pressure or rebound tenderness only in the lower left abdomen; and if there are no alarm signals.

• Alarm signals of complicated diverticulitis are: guarded muscle response, signs of intestinal obstruction, locally palpable resistance, rectal loss of blood, hypotension, and high fever.

• The policy for uncomplicated diverticulitis is waiting without specific measures, provided that the general practitioner monitors the course actively.

• There is no indication for antibiotics in patients with uncomplicated diverticulitis.

• Patients with signs of complicated diverticulitis or with persisting symptoms should be referred.