Diverticulitis
is a common condition of the large bowel found, usually, in
middle-aged or older people in the developed world. The most
likely cause of the condition is a refined diet with inadequate
fibre content. This diet results in a slowing down of the passage
of waste products through the large bowel and abnormal muscular
activity in the bowel wall. This leads to the development, in
the wall of the bowel, of little pouches, diverticuli. These
diverticuli may be present but cause no trouble at all. They
may, however, be associated with some bowel discomfort and bowel
irregularity. The most serious consequence of diverticuli, however,
is when they become infected and inflamed. This is called "diverticulitis". Diverticulitis can vary in severity from a transient, localised pain, usually in the left side of the abdomen, often associated with diarrhoea and a temperature, to a life-threatening acute condition in which the bowel may be perforated giving rise to peritonitis (as can happen in appendicitis) or in which the bowel may be completely obstructed by swelling and inflammation (as can happen in cancer of the bowel). Severe diverticulitis can also result in acute loss of blood from the bowel. Most patients do not have these severe complications but have recurrent discomfort.
A life-long healthy intake of adequate fibre will, most likely, prevent the onset of diverticular disease. Once established, however, in its mildest form the condition may be greatly helped with additional fibre intake (see Constipation). Acute inflammation needs to be treated with the appropriate antibiotic from the doctor. Pain killers and anti-spasmodics may also help, in the most severe cases, surgery may be necessary and resection of the bowel is sometimes required. It is always necessary to investigate diverticulitis as it can mimic cancer of the bowel and is sometimes found in the same patient, making diagnosis even more difficult. As cancer of the bowel is one of the cancers which has a good prognosis when discovered early it is essential it should not be missed. When suspected, most cases of diverticulitis will be investigated by means of barium enema and colonoscopy. |
