Diverticular Disease
in middle aged men

Diverticular disease
Is what occurs when small pouches form in your colon, called Diverticulum.
(Or if there is more than one Diverticula)

They're formed by a weakened part of the bowel wall being 'pressured', by over-solid fecal matter. (crap)
sort of like a bike innertube poking through a hole in the tyre.

The forming of Diverticula is quite common.

About 10% of people in the western world over 40 have some Diverticula,

Rising to 50% of the over fifties.

The overall condition is known as Diverticulosis, and in the majority of people it goes unnoticed..

It is thought to be caused, or made worse by low fibre diet.

Low fibre diets cause constipation/hard stool. which needs more pressure to pass.
This pressure is what causes Diverticulum to form.

The reason lack of fibre is thought to be the cause, is that Diverticular Disease is virtually unknown in Africa, and large parts of Asia, where the diet contains lots of fibre.

Also, it was first noticed in the early 1900's when processed foods (low fiber)
first appeared.

Lack of exercise is thought to be a major contributor to constipation, along with insufficient water intake.
(Can you see where this is leading?)

For information about diet see the Losing Weight page on this site, there is also lots of help on the Exercise page.

It's also on the increase.

Between 1986 and 2000, there was an increase of 50% in cases of Diverticular disease in the developed world.

In some cases of Diverticular Disease, these pouches can get blocked, and become infected.
When this happens it's known as...

('itis' means inflamed like tonsillitis, appendicitis etc.)

Diverticulitis is a painful condition which is relatively easily treated with antibiotics.

But if the infection is'nt treated, it can lead to all kinds of nasty things.

The diverticulum can develop into an Abcess,
Which is a puss filled sac, that can perforate, allowing the infection and fecal matter into the abdominal cavity. Causing a potentially fatal infection called Peritonitis.

Or it can become attached to another part of the gut, or an adjascent organ, and form something called a Fistula.

A Fistula is when two pieces of infected tissue come in contact with each other, and grow together.
The most common site is between the colon and the bladder.
This leads to chronic urinary infections wher fecal matter leaks into the bladder.
(not nice.)
It can also happen between the colon, and the outer wall of the abdomen, with similar leakage.

Diverticulitis can also cause scar tissue to form on the inside of your Colon.
Which can partially, or completely block it.

So your ma was right when she told you to eat your vegetables.

Symptoms of diverticular disease

The symptoms of Diverticulitis usually start with pain in the lower left area of the abdomen.
This can vary from a dull ache, to agonizing sharp pain. It often gets worse after eating, and eases after emptying the bowels.
The area around the pain is often tender to touch.
There can also be bloating, cramping, vomiting, fever, and chills, often accompanied by a change in bowel movement.

In some cases, (although quite rare) there is also rectal bleeding. Caused by the bursting of small blood vessels in the colon, which are stretched by the forming of Diverticulum.

The trouble is...
Diverticular disease symptoms are very similar to the symptoms of several other diseases of the digestive tract, such as...

  • Irritable Bowel Syndrome
  • Stomach ulcers
  • Colon Cancer
  • Crohnes Disease
  • Appendicitis
  • Colitis

So these have to be eliminated first.
Usually by...

CT Scan
This is a special computerised X ray machine. That divides your body into slices
A dye is either injected or swallowed which shows up the outline of the area under examination.
Barium enema
A solution containing the element Barium is injected into the colon via the rectum.
This shows up Diverticulum on X ray
A flexible 'telescope' is inserted through the rectum and passed up through the colon to visually inspect it.This is used more to eliminate cancer than to detect Diverticular Disease.
Blood tests
Will often show raised white cell count if an infection is present.
X Ray
Can often show up Abcesses
Treatment of Diverticular Disease.
Treatment of Diverticulitis first centers on clearing up infection and resting the colon.
This is done by treatment with antibiotics, and usually a period of 'light' diet I.e. low fibre/liquid, to rest the inflamed area.
Pain relief is usually by paracetemol.

This is usually enough to 'cure' a bout, then you can return to a high fibre diet to prevent a recurrence.

In the case of severe recurring Diverticulitis, Abcesses, or Fistulas.
Surgery is usually carried out.

This is usually a quite simple case of removing the guilty part of the colon, and stitching the two ends together.

But it occasionally might need a Colostomy.

In this process, a hole is made in the abdominal wall.
The 'cut' end of the colon is stiched to it, and a bag is attached to collect the waste.

This gives the other part of the colon and Rectum a chance to recover.
Later, after it has recovered it's re-attached in another operation.

Living with Diverticular Disease...
Most people with diverticular disease never know they have it.
But even if you have 'problem' DD you can live a pretty 'normal' life.
You've just got to watch what you eat as in eat plenty of fiber maybe even take a 'Bulking' supplement such as Fybogel.
There used to be a theory that you musn't eat nuts or seeds, but this has now been pretty much disproved.

So provided you eat well and take a bit of exercise. (see the Losing Weight page also the Exercise page.

You should be able to cope pretty well.

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