Inside Scope

Welcome to the first in a series of new podcast episodes from the pages of Gastroenterology, the flagship journal of the American Gastroenterological Association and the most prominent journal in the field of gastrointestinal disease. This podcast series covers articles in the journal’s “Gastro Grand Rounds” section, which features discussions among multidisciplinary teams of experts on the management of complex clinical cases. Gastro Grand Rounds: Managing Diverticulitis Dr. G.S. Raju, editor of the Gastro Grand Rounds section in Gastroenterology, is joined by Dr. Lisa Strate to discuss her article, “Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder.” https://www.gastrojournal.org/article/S0016-5085(23)00042-2/fulltext Dr. Strate is a professor of medicine at the University of Washington School of Medicine and is the section head of gastroenterology at Harborview Medical Center. Dr. Strate’s research has examined risk factors for the development of diverticular disease. Her work has informed the development of guidelines, dietary recommendations, and measurements for the prevention of diverticulitis. She has investigated the role of chronic inflammation and the gut microbiome in diverticulitis. She is a fellow of AGA. [0:27] Introduction of the author. [2:20] The utility of CT in evaluating diverticulitis. [5:49] Managing a patient with uncomplicated diverticulitis. [11:00] Take-home instructions for the patient. [14:12] Preparing the patient colonoscopy, strategies used during the procedure, and documenting findings. [19:11] Utility of a barium enema. [20:22] The patient returns and has left lower quadrant pain. What are the next steps? [24:30] Laying out the pros and cons of continued medical management compared with surgery for a patient who has recurrent episodes of uncomplicated diverticulitis. [28:00] Does the author’s institution have a support group for patients? [28:55] What is the longest period of antibiotics the author has given to a patient who does not want surgery? [30:34] Take-home messages for fellows and residents. Thank you for listening. Find this and other articles on our website at https://www.gastrojournal.org. We welcome your feedback. Please email us at gastro@gastro.org. This discussion was recorded on Sept. 5, 2023, and reflects medical knowledge at that time. The views and opinions expressed in this podcast are those of the individual speakers only and do not necessarily represent those of the American Gastroenterological Association. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice.