Supplemental Material for: Guidelines for Colonic Diverticular Disease—2026, Second Edition: Management of Diverticular Bleeding and Acute Diverticulitis

These guidelines aim to provide Japanese and Asian evidence-based consensus that complements Western guidelines. Recommendations for acute LGIB and diverticular bleeding are as follows: risk stratification with the Shock Index and Oakland and NOBLADS scores guides triage; pre-colonoscopy contrast-enhanced computed tomography is the widely used diagnostic modality; routine colonoscopy within 24 h is not suggested for all patients; endoscopic band ligation or direct clipping is suggested post-detection of stigmata of recent hemorrhage; and early oral refeeding is suggested.

Recommendations for diverticulitis are as follows: post-resolution colonoscopy is suggested to exclude colorectal cancer; outpatient treatment and withholding of antibiotics are suggested in selected uncomplicated cases; and primary anastomosis may be favored over Hartmann’s procedure in selected complicated cases. </p>