Symptomatic
diverticular disease has a high prevalence in countries with a western lifestyle. Besides
antibiotics for acute
diverticulitis there are no established medical interventions to prevent or to treat symptomatic
diverticular disease. Due to its broad spectrum of anti-inflammatory activities,
mesalazine is a candidate for the treatment of symptomatic
diverticular disease. A review of the literature shows that randomized open studies using various treatment designs suggest a protective role of
mesalazine in preventing recurrences of
diverticulitis. Currently, 5 randomized placebo-controlled trials are active which will clarify the role of
mesalazine to prevent recurrence of
diverticulitis in the near future. Several randomized uncontrolled studies suggest that
mesalazine improves symptoms in patients with symptomatic uncomplicated
diverticular disease. The analysis of secondary end points from two randomized placebo-controlled trials suggests that
mesalazine improves symptoms in
diverticular disease although both studies failed to show a statistically significant advantage for
mesalazine for the primary study end point. In segmental
colitis associated with
diverticulosis no prospective systematic studies are available. However, several case reports show a high efficacy of
mesalazine in segmental
colitis associated with
diverticulosis.