New guidelines aim to improve diverticulitis treatment

This issue includes stories on managing diverticulitis, using direct oral anticoagulants, and payment and performance measures.

Antibiotics used to be routinely prescribed for patients with diverticulitis, but that tide is beginning to turn. New guidelines from ACP on diagnosis and management of acute left-sided colonic diverticulitis, published in January, suggest against initial management with antibiotics for most patients, and guidelines from subspecialty societies have done so as well. ACP's guidelines also offered recommendations on referral for colonoscopy after a diverticulitis episode. Senior Writer Mollie Frost reviews the latest guidance and talks to experts about the best ways to communicate it to patients.

Antithrombotic therapy for venous thromboembolism is another area where research continues to evolve, spurred in part by the advent of direct oral anticoagulants (DOACs), which came on the scene more than 10 years ago. The drug class offers an attractive alternative to low-molecular-weight heparin for some patients, but decision making about duration of therapy, use in special populations, and other factors can be increasingly complex. Our story in this issue updates internists on new and different treatment recommendations as well as ways to handle challenges in prescribing.

Payment and performance measures can have a large effect on internists' practice, but their inner workings can often seem mysterious. Two articles in this issue aim to shed some light. A Practice Tips column from ACP's Washington, D.C., office gives an inside look into how a code becomes a code and ACP's role in the multistep process, and a Q&A with Peter Basch, MD, MACP, explains why ACP's Performance Management Committee does not support the MIPS performance measure on controlling high blood pressure.

This issue's Pearls from I.M. Peers column features Kimberly N. Sims, MD, FACP, a primary care internist in Houston. Read her advice on getting comfortable talking about obesity with patients, then watch a related video on teaching portion control.

Other stories in this issue focus on diagnosing primary hyperparathyroidism and avoiding discriminatory language in the electronic health record. Finally, our conference coverage this month is from the American Academy of Allergy, Asthma, & Immunology Annual Meeting, which was held virtually and in Phoenix in February. Read the latest take on use of cardiovascular medications such as beta-blockers and angiotensin-converting enzyme inhibitors in patients with insect allergy.

Speaking of conferences, ACP's Internal Medicine Meeting 2022 takes place in Chicago April 28-30. Watch these pages, and your email, for comprehensive coverage.


Jennifer Kearney-Strouse
Executive Editor