Continuing Medical Education Questions: July 2026

Article Title: ACG Clinical Guideline: Colonic Diverticulitis LEARNING OBJECTIVE After this activity, the participant will be able to discuss evidence-based recommendations for the management of diverticulitis in the outpatient setting. CASE 1 A 48-year-old man presents to the clinic complaining of acute onset of fever to 101 F and left lower quadrant abdominal pain for the last 24 hours. He is tolerating oral intake. He denies significant past medical history and has not had any surgeries. He has not been experiencing any issues with unintentional weight loss, change in bowel habits, anemia or blood in his stool. Within the past year, he underwent a screening colonoscopy that was significant for diverticulosis involving the rectosigmoid colon, the sigmoid colon and the descending colon. His abdomen is tender on your examination, but he does not exhibit any peritoneal signs. He is hemodynamically stable and the remainder of his examination is otherwise normal. You obtain a computed tomography (CT) abdomen/pelvis with contrast and it is read as colonic wall thickening with increased pericolic fat stranding of the sigmoid colon without associated abscess, perforation, stricture or fistula. QUESTION 1 What is the next step in managing this patient? Start treatment with amoxicillin-clavulanic acid 875 mg/125 mg orally every 12 hours for 7 days Plan for an outpatient colonoscopy to be performed in 6–8 weeks after his acute diverticulitis flare has resolved to exclude colon cancer Advise the patient to have clear liquids for the first few days to allow easier passage of stools through the inflamed colon Advise the patient to refrain from eating nuts, corn, seeds, and popcorn during the acute episode as well as to prevent future episodes QUESTION 2 Which statement is the most accurate describing the role of surgery in colonic diverticulitis? Elective colectomy is recommended after 2 episodes of acute uncomplicated diverticulitis as the risk of developing complicated diverticulitis increases Patients with recurrent, uncomplicated diverticulitis that significantly impairs quality of life should be given a surgical referral to discuss the risks and benefits of elective colon resection Elective surgery eliminates the risk of recurrence of acute diverticulitis Young patients with acute diverticulitis have a high risk of recurrence or complicated disease and therefore should undergo elective resection after a single episode of acute diverticulitis QUESTION 3 You are seeing a 53-year-old woman in your clinic who is presenting for follow-up after an episode of acute uncomplicated diverticulitis 5 weeks ago. On examination, she is afebrile and hemodynamically stable with a benign abdominal examination. Her body mass index is 34.8. She reports doing well and would like to know what she can do to prevent any further episodes of diverticulitis. Which statement is the most accurate regarding reducing risk of recurrence of diverticulitis? Start rifaximin Start probiotics Start mesalamine Recommend healthy weight loss