Summary: Diverticular disease, due to its frequency and variety of symptoms, as well as the difficulties in diagnosis and treatment is a challenge for primary care physicians. Over the years, incidence of symptomatic disease increases. The etiology of the disease is poorly understood. Currently fecal micorbiota alteration and chronic minimal inflammation are considered as two main causes of symptoms. In symptomatic uncomplicated diverticular disease (SUDD) the main symptom is abdominal pain, usually in the left lower quadrant, but changes in bowel habits and bloating may be present. If, additionally, there are general symptoms of inflammation (fever, abnormal lab findings) diagnose is acute diverticulitis, which may wary from mild to complicated. Fortunately life-threatening complications are rare. The main role in the diagnosis plays computed tomography (CT), which is not available for family physicians. Colonoscopy is not intended to identify diverticulitis, and often is contraindicated due to possible complications. Abdominal ultrasound is a very good diagnostic method which can be used in the first step of the diagnostic process. Treatment depends on the severity of the disease symptoms. Asymptomatic individuals usually requires only dietary modification (diet rich in soluble fiber), probiotic and butyrate. In SUDD it is necessary to add an eubiotic affecting the microbiota and inflammation. Currently there is only one, rifaximin which is used cyclically, for 7 days once in month for years. Many studies have confirmed that systemic antibiotics are not superior than placebo in the treatment or uncomplicated diverticular disease or inflammation, and should not be used routinely.