gastrointestinal disorders
Colonic Diverticulitis
Segmental Colitis Associated With Diverticulosis (SCAD)
Segmental colitis associated with diverticular disease refers to chronic colonic inflammation affecting the interdiverticular mucosa. Diagnosis is by endoscopy. Treatment is symptomatic. (See also Colonic Diverticulosis .) Segmental colitis associated with diverticulosis (SCAD) and chronic recurrent Colonic Diverticulitis are terms used to describe chronic colonic inflammation attributed to The cause of SCAD is unknown and may be multifactorial. Mucosal prolapse, fecal stasis, localized ischemia, alterations in the gut microbiota, and/or chronic inflammation may play a role. It is unclear how much the relationship between the diverticulosis and colitis is causal, is due to a common underlying factor, or is coincidental: the histologic characteristics contain features similar to those seen in Overview of Inflammatory Bowel Disease , infectious colitis, and Symptoms of SCAD include hematochezia, abdominal pain, and diarrhea. The diagnosis of SCAD is suggested when endoscopy reveals erythematous, friable, and granular mucosa with either a diffuse or patchy distribution involving the interdiverticular mucosa. Treatment of SCAD is symptomatic; to date, high-quality randomized clinical trials have not been done. Initial treatment with the oral antibioticsciprofloxacinandmetronidazoleis recommended. In patients who do not improve with antibiotics, oral preparations of 5-aminosalicylic acid (5-ASA) can be used. Corticosteroids (eg,prednisone) are used for refractory cases. Surgery (segmental colectomy) is an option for patients with corticosteroid-refractory or corticosteroid-dependent SCAD. 