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. Author manuscript; available in PMC: 2020 Apr 1.
Published in final edited form as: Gastroenterology. 2019 Jan 17;156(5):1282–1298.e1. doi: 10.1053/j.gastro.2018.12.033

Table 3.

Areas of Unmet Need in Diverticular Disease

Epidemiology
  Delineate factors associated with the rapid rise in diverticulitis incidence among young patients
  Understand the long-term, global impact of acute diverticulitis on patients
  Identify markers (clinical and biomarkers) of risk of disease progression/recurrence
  Examine sex and racial differences in the incidence of diverticulitis
  Define the natural history of diverticulitis in immunocompromised patients
Pathogenesis
  Determine the role of systemic and mucosal inflammation in the development diverticulitis
  Examine prospectively the gut microbiota and related metabolites in diverticulitis
  Clarify risk genes within genetic risk loci associated with diverticulitis and determine mechanisms
  Delineate the role of connective tissue and enteric nerve abnormalities in diverticulitis
Medical Treatment
  Develop accurate clinical prediction tools to aide in the diagnosis and triage of acute diverticulitis
  Examine the role of ultrasound in the diagnosis of diverticulitis (in the U.S.)
  Define the long-term consequences of withholding antibiotics in uncomplicated diverticulitis
  Compare dietary strategies in the treatment of uncomplicated diverticulitis
  Study pain control strategies for complicated and uncomplicated diverticulitis
Surgical Treatment
  Compare outcomes in patients undergoing surgery vs no surgery for recurrent diverticulitis
  Understand long-term outcomes of medical vs surgical treatment of complicated diverticulitis
  Identify predictors of postoperative complications
  Identify predictors of resolution of symptoms following surgical resection
  Determine the optimal timing of surgery among patient with persistent inflammatory symptoms
  Evaluate the modern prognostic value of the Hinchey classification system
Prevention
  Define the role of diet and lifestyle modification in the prevention of recurrent diverticulitis
  Develop and test new pharmaceutical agents in the prevention of recurrent diverticulitis
  Compare medical vs surgical approach to prevention of recurrent diverticulitis
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