{
  "abstract": "Introduction Colonic diverticulosis is the most common structural abnormality of the colon in developed countries, with an increasing global prevalence. Approximately 20–25% of affected individuals develop symptoms, collectively referred to as diverticular disease. Given its wide clinical spectrum, evolving pathophysiological insights and growing disease burden, updated guidance is essential.Methods This International Consensus, developed by 32 experts from 14 countries through a structured Delphi process based on the PICO framework and GRADE methodology, provides evidence-based recommendations across five domains: epidemiology and pathogenesis; clinical features; diagnosis; medical therapy; and surgical management.Results Key statements define diverticulosis as the presence of diverticula without symptoms and diverticular disease as diverticula associated with symptoms or complications. High dietary fibre intake is protective whereas smoking, obesity and the use of non-steroidal anti-inflammatory drugs, corticosteroids, opioids or immunotherapy increase risk. Imaging is essential in suspected acute diverticulitis: ultrasound may be appropriate in experienced hands, while CT remains preferred for complicated cases. Diverticulosis itself requires no treatment. In symptomatic uncomplicated diverticular disease, dietary fibre, selected probiotics, mesalazine and rifaximin may help relieve symptoms. Routine antibiotic use is not recommended for acute uncomplicated diverticulitis, and elective surgery should be individualised, prioritising quality of life considerations over episode count.Conclusions These Consensus statements aim to standardise and optimise the diagnosis, management and prevention of diverticular disease across diverse healthcare systems, while highlighting research priorities such as microbiome characterisation, genetic risk profiling and long-term outcomes of selective antimicrobial and surgical strategies.",
  "authors": [
    {
      "affiliations": [
        "Territorial Gastroenterology Service, ASL BAT, Andria, Italy",
        "Department of Medical and Surgical Sciences, Catholic University, Rome, Italy"
      ],
      "name": "Antonio Tursi"
    },
    {
      "affiliations": [
        "Humanitas University Consortium, Rome, Italy"
      ],
      "name": "Giovanni Brandimarte"
    },
    {
      "affiliations": [
        "Department of Clinical and Experimental Medicine, Gastroenterology Unit, University of Parma, Parma, Italy"
      ],
      "name": "Francesco Di Mario"
    },
    {
      "affiliations": [
        "Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Wenjie Ma"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania"
      ],
      "name": "Juozas Kupcinskas"
    },
    {
      "affiliations": [
        "Gastroenterology, Medical Centre for Postgraduate Education, Warsaw, Poland",
        "Gastroenterology, Maria Sklodowska-Curie Memorial Cancer Centre, Warsaw, Poland"
      ],
      "name": "Jaroslaw Regula"
    },
    {
      "affiliations": [
        "Gastroenterology, L.Sacco University Hospital, Milan, Italy"
      ],
      "name": "Giovanni Maconi"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg",
        "LMU Klinikum Medizinische Klinik und Poliklinik II München, Magdeburg, München, Germany"
      ],
      "name": "Peter Malfertheiner"
    },
    {
      "affiliations": [
        "Department of Medical and Surgical Sciences, University of Bologna",
        "IRCCS Azienda Ospedaliero-Universitaria St Orsola, Bologna, Italy"
      ],
      "name": "Giovanni Barbara"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Alta Bates Summit Medical Center, East Bay Center for Digestive Health, Oakland, California, USA"
      ],
      "name": "Neil Stollman"
    },
    {
      "affiliations": [
        "King’s College London",
        "IASO General Hospital, London, Athens, UK, Greece"
      ],
      "name": "Savvas Papagrigoriadis"
    },
    {
      "affiliations": [
        "Department of General and Digestive Surgery, Bellvitge University Hospital and IDIBELL, Barcelona, Spain"
      ],
      "name": "Thomas Golda"
    },
    {
      "affiliations": [
        "Department of General Surgery, Imperia Hospital, Imperia, Italy"
      ],
      "name": "Antonio Amato"
    },
    {
      "affiliations": [
        "Instituto Goiano de Gastroenterologia e Endoscopia digestiva, Departamento de Clínica Médica, Disciplina de Gastroenterologia da Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, Goiás, Brazil"
      ],
      "name": "Mauro Bafutto"
    },
    {
      "affiliations": [
        "Department of Medicine and Surgery, Gastroenterology and Hepatology Unit, ‘Santa Maria della Misericordia’ University Hospital, Perugia, Italy"
      ],
      "name": "Gabrio Bassotti"
    },
    {
      "affiliations": [
        "General Surgery, BioMedical Institute, Genova, Italy"
      ],
      "name": "Gian A Binda"
    },
    {
      "affiliations": [
        "Department of General and Digestive Surgery, Bellvitge University Hospital and IDIBELL, Barcelona, Spain"
      ],
      "name": "Sebastiano Biondo"
    },
    {
      "affiliations": [
        "Department of Medicine and Surgery, University of Parma, Parma, Italy"
      ],
      "name": "Pellegrino Crafa"
    },
    {
      "affiliations": [
        "Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania, Cluj-Napoca, Romania"
      ],
      "name": "Dan Dumitrascu"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, S. Camillo Hospital, Rome, Italy"
      ],
      "name": "Walter Elisei"
    },
    {
      "affiliations": [
        "Department of Radiology, ASST Fatebenefratelli Sacco, Milano, Lombardia, Italy"
      ],
      "name": "Nicola Flor"
    },
    {
      "affiliations": [
        "Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, and Gleneagles Hospital, Singapore"
      ],
      "name": "Kok Ann Gwee"
    },
    {
      "affiliations": [
        "National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre, University of Nottingham School of Medicine, Nottingham, UK"
      ],
      "name": "David James Humes"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Palliative Medicine, International University Health and Wellfare, Narita Hospital, Chiba, Japan"
      ],
      "name": "Takaomi Kessoku"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Cologne, Cologne, Germany"
      ],
      "name": "Wolfgang Kruis"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Assuta Ashdod Medical Center, Ben Gurion University of the Negev, Ashdod, Israel"
      ],
      "name": "Adi Lahat"
    },
    {
      "affiliations": [
        "Gastroenterology, University Hospital, Zaragoza, Spain"
      ],
      "name": "Angel Lanas"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, International University Health and Wellfare Graduate School of Medicine, Narita, Japan"
      ],
      "name": "Atsushi Nakajima"
    },
    {
      "affiliations": [
        "Division of Surgery, ‘P. Colombo’ Hospital, ASL RM6, Velletri, Rome, Italy"
      ],
      "name": "Marcello Picchio"
    },
    {
      "affiliations": [
        "Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK",
        "NIHR Nottingham Biomedical Research Centre, Nottingham, UK"
      ],
      "name": "Robin C Spiller"
    },
    {
      "affiliations": [
        "University of California Berkeley, Berkeley, California, USA"
      ],
      "name": "Athena Adamopoulos"
    },
    {
      "affiliations": [
        "Department of Health Sciences, United Campus of Malta, Msida, Malta"
      ],
      "name": "Carmelo Scarpignato"
    }
  ],
  "title": "Global guidelines on diverticular disease of the colon: the Fiesole Consensus report",
  "uid": "a1558c3f-2f44-5721-8df3-d815bf7db213"
}