Diverticular disease

Dr Mary Griffiths gives an overview of the disease

What is diverticular disease?

Diverticular disease is caused when the large bowel becomes deformed. The bowel wall breaks down and the inner layers stick out through the wall, looking like grapes on the outside of the colon. There can be few of these pouches - called diverticula - or the whole colon can be affected. Although younger people can be affected by diverticular disease, it is more common in older people. Approximately half of the people in the UK over 60 have the disease (over 5 million people).

Diverticular disease can cause a wide range of symptoms and many people show no signs of the problem. At its worst, diverticular disease is a debilitating and recurring syndrome with life-threatening complications. Nobody knows what causes the nasty symptoms to develop.

What are the effects of diverticular disease?

Pain, sometimes completely incapacitating, is the most common symptom and can last for days, weeks or months. There are attacks of constipation and/or diarrhoea, urgency, excessive gas, bloating and passing mucous. Some patients have bleeding from the back passage, either as an energy-sapping long-term condition or a sudden severe haemorrhage.

The diverticula are likely to become infected by trapped faeces and repeated bouts of this inflammation (diverticulitis) can lead to serious problems such as fistula being formed between the bowel and other organs in the abdomen. Lifestyle and quality of life are seriously affected by such symptoms; having easy access to a toilet is often extremely important.

Attitudes towards the disease can cause stress and anguish. It is distressing to be constantly told that you do not have symptoms, that pain is all in your mind, there is nothing wrong with you but old age, that nothing can be done but to learn to live with it. But this is often the message given.

Relationships can be devastated when family members are told that there is nothing wrong. Some people feel that they have to hide their problems so as not to be considered "attention seeking".

There is no specific treatment for diverticular disease and there has been little research. Commonly people are told to think positively and eat more fibre.

The usual approach is to treat the particular symptoms of an individual. For example one person may require regular laxatives while another may need to take anti-diarrhoea drugs. A person has to become an "expert-patient" in their own care.

Probably the most widely used treatment is soluble fibre which can be found in food like oats and stewed apples. This can help both extremes of bowel habits (diarrhoea and constipation), but there are some people who cannot take soluble fibre because it can cause gas.

Diverticular disease sufferers feel abandoned by orthodox medicine. They can be lonely with lack of information, help and support and have to try desperately to find treatment themselves.

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