The Curbsiders Internal Medicine Podcast #510 Diverticulitis for the Hospitalist
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Jan 5, 2026 Dr. Bob Hollis, a colorectal surgeon specializing in diverticulitis and Dr. Andrew Webster, an infectious diseases physician, dive deep into managing diverticulitis. They clarify how to distinguish between uncomplicated and complicated cases, discussing when to use antibiotics and the importance of imaging. Surgical perspectives are shared, particularly on abscess management and the significance of deciding when to involve surgery. Nutrition advice for hospitalized patients rounds out their discussions, alongside debunking common myths around diet and diverticulitis.
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Go Fast, Go Slow
- Bob Hollis's best advice as a surgeon: know when to go fast and when to go slow.
- He applies this both in the OR and in clinic and at home with family.
IV Choices For Admission
- For admitted patients without resistant-risk factors, IV ceftriaxone plus metronidazole provides reliable initial coverage.
- Reserve broader anti-pseudomonal or carbapenem regimens for nosocomial, recent-antibiotic, or ESBL risks.
Cancer Risk After Diverticulitis
- The post-diverticulitis colon cancer risk is low after uncomplicated episodes (~≤2%) and higher after complicated disease.
- Use colonoscopy selectively after complicated presentations to exclude malignancy.
