DIVERTICULAR DISEASE

What is it?

Diverticular disease is a condition of the large bowel (or gut) where small pouches of gut lining poke out through the wall like little balloons. These pouches are called diverticula. If these pouches get inflamed the condition is known as diverticulitis.

What causes it?

Diverticular disease is probably caused by the pressure inside the large bowel being raised, which forces pockets of bowel lining out through the muscle which surrounds the outside of the bowel. This raised pressure is probably caused by constipation from a low-fibre diet.

Who gets it?

Diverticular disease is very rare in Africa, where most people have a high-fibre diet. If you have a low-fibre diet with not enough vegetables, fruit and roughage, you will be more likely to get diverticular disease. The older you get, the more likely you are to suffer from it.

What are the symptoms?

You may first notice pain over the bottom part of your stomach, often on the left-hand side. The pain may come and go in waves. You may notice that your bowel habit changes, with constipation or constipation and diarrhoea in turns. If you have had diverticular disease for some time, you may notice that your stomach swells sometimes and you get a lot of gas and stomach rumbling. Sometimes the pain comes on - or gets worse - suddenly and you might feel extremely unwell with a fever. This means one of the diverticula is inflamed or infected.

When should I see my doctor?

If you have persistent pain in your lower stomach you should make an appointment with your GP for a check-up. If your bowel habit changes suddenly - especially if you also have pain and bleeding from the back passage - you should make an appointment as soon as possible. If the pain is very severe and you feel generally unwell and feverish you may need to call a doctor out.

What tests will my Doctor want to do?

Your doctor will ask you some questions and examine you. He or she may want to examine your back passage as well. If your symptoms are very severe your GP may send you to hospital for further tests. One of these involves putting a special telescope into the large bowel from the back passage to look at the inside of the bowel. Another involves pumping air and a special fluid into your bowel through the back passage and taking X-rays.

What is the short-term treatment?

If your symptoms are mild your doctor will advise you about taking more fibre in your diet. This means plenty of fruit and vegetables, wholemeal bread and bran. If you have severe symptoms suggesting inflammation or infection, you will probably need to go into hospital for antibiotics and a drip. Very occasionally you may need an operation.

How can I stop it getting worse?

The most important way of helping yourself is avoiding constipation. This includes taking plenty of fibre in your diet, drinking enough fluids and staying physically active. You are unlikely to need any other long-term treatment.