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Diverticular Disease

FCO / AC March 2015 Diverticular Disease V1

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What is Diverticular Disease?

Diverticular disease is when small bulges or pockets develop in the lining of the intestine. Diverticulitis is when these pockets become inflamed or infected. ‘Diverticula’ is the medical term used to describe the small bulges that stick out of the side of the large intestine (colon). Diverticula are common and associated with aging. The large intestine becomes weaker with age, and the pressure of hard stools passing through the large intestine is thought to cause the bulges to form.

It is estimated that 5% of people have diverticula by the time they are 40 years old and at least 50% of people have them by the time they are 80 years old.

 

Who is affected?

Diverticular disease is one of the most common digestive conditions. It is often described as a ‘Western disease’ because the rates are high in European and North American countries, and low in African and Asian countries. A combination of genetics and diet is thought to be the reason for this and the fact that Western countries tend to eat less fibre.

Both sexes are equally affected by diverticular disease, although the condition is more likely to appear at a younger age (under 50) in men more than women. Overall, symptoms of diverticulitis are more likely to occur in people over the age of 70 years.

 

What are the symptoms of diverticular disease and diverticulitis?

Diverticular disease does not usually cause any symptoms apart from some lower abdominal cramps. Your pain may come and go, or it may be constant. It often starts after you've had a meal and gets better when you pass wind or a stool. You may also feel bloated and notice a change in your bowel habits, with your stools getting looser or, more often, harder.

Very occasionally a diverticulum may become inflamed or infected. This is a condition known as diverticulitis, sometimes these pockets may bleed. When this happens, you may see blood in your stool but the bleeding usually stops by itself and doesn't need treatment. It usually presents with lower abdominal pain, bowel irregularity and fever. Such symptoms should be reported to your GP.

 

What treatments work?

Antibiotics are the main treatment for diverticulitis. If you have a serious infection you may need to be treated in hospital with antibiotics through a drip (intravenous infusion or IV).

 

Other treatments your doctor may try

Laxatives can help if you have constipation. There are different types, including bran and ispaghula husk. You can buy unprocessed wheat bran and various products containing ispaghula husk from a pharmacy or a health food shop. Some brand names are Fybogel and Regulan or Lactulose (brand name Regulose) is another type of laxative. But it can cause abdominal pain, wind and stomach cramps and make you feel sick. It can cause wind and abdominal pain.

 

What can you do to control your symptoms to prevent diverticulitis?

People with diverticular disease are often advised to eat more foods that are high in fibre or to take fibre supplements. Foods that are high in fibre include wholegrain cereals, apples, pears, carrots, spinach, squash, broccoli, potatoes, baked beans, and kidney beans.

It is very important to avoid constipation and to ensure regular bowel function. Laxatives should be used with caution as they can worsen the condition. If in doubt, you should consult your GP. A much better way of avoiding constipation is to eat a balanced diet with extra fibre.

  • Use wholemeal rather than brown bread as it has a higher fibre content.
  • When baking use wholemeal rather than white flour.
  • Add unprocessed bran to the diet, either in the dry state or mixed with other foods.
  • Fresh fruit and vegetables should be taken at least twice a day.
  • Remember that the skins of some fruit and vegetables are often rich in fibre, eg apples, pears, tomatoes and potatoes.
  • Avoid excessive amounts of sugar, sweet or fatty foods.

 

Surgery

If you get a serious infection or a blockage in your colon you may need emergency

surgery. In this operation, your surgeon cuts away the damaged part of your colon and joins the healthy sections back together. It's called colonic resection. This is sometimes because the antibiotics haven't worked or because of complications. Here are the most common complications.

  • An abscess in your colon. An abscess is made up of infected pus and can cause swelling.
  • A fistula. This is an abnormal connection of tissue between your colon and other nearby organs, such as your bladder, your small intestine (gut), or your skin.
  • A blockage. This can affect your bowel movements.

 

Some points to remember

It will take several weeks for your bowel habit to improve and the full benefits may not be realised for many months. To maintain a healthy lifestyle, regular exercise will complement a balanced diet.

 

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