Diverticular disease is a common bowel condition, the pathogenesis of which is incompletely understood. Acute exacerbations
of diverticular disease usually require dietary changes, antibiotic therapy, and may necessitate urgent surgery. Approximately
25–33% of patients experience symptomatic and acute inflammatory disease recurrence, suggesting that current long-term management
is inadequate. Because inflammatory complications of diverticular disease, including diverticulitis, are similarities to inflammatory
bowel diseases, evidence suggests that patients may respond to anti-inflammatory therapies used in these conditions. Here,
we explore the rationale and evidence for use of inflammatory bowel disease treatment, namely 5-aminosalicylic acid (5-ASA;
mesalamine), in diverticular disease, and review clinical data on the efficacy of mesalamine either alone or in combination
with other agents for the treatment of diverticular disease. PubMed and conference abstracts were searched for clinical studies
examining the use of mesalamine in treating diverticular disease. Studies were evaluated for treatment efficacy in symptom
reduction, recurrence prevention, or improving quality of life. The results of our search suggest that single-agent mesalamine
can reduce diverticular disease symptoms and improve quality of life more effectively than antibiotic treatment alone. Mesalamine
in combination with antibiotics can also reduce symptoms and improve quality of life with greater efficacy than either treatment
alone. Combining mesalamine and probiotics treatments may reduce recurrent attacks of diverticular disease. Further randomized,
well-controlled studies are required for validation; however, it seems that mesalamine is an important agent in future diverticular
disease management.
Keywords Diverticular disease – Mesalamine – 5-Aminosalicylic acid – Inflammation