Spotting the signs

It’s an age-related digestive condition not everyone has heard of, but we all need to watch for the symptoms of potentially life-threatening diverticulitis

In a bid to shake off a nagging pain in her stomach, Margaret Glanville headed to her usual exercise classes at the gym.

A few hours later, she was in agony, running a fever and being told by doctors that she had peritonitis – a life-threatening inflammation of the membrane which lines the wall of the abdomen.

The root cause of her illness was diverticulitis, a condition in which diverticula – bubble-like pouches – develop on the wall of the colon and then become irritated or infected.

More than half of over-50s develop diverticula but most experience no discomfort. Some people – around one in four – develop diverticular disease with symptoms including abdominal pain and diarrhoea.

The more serious diverticulitis is diagnosed when a pouch becomes inflamed and the patient has symptoms such as severe pain, nausea and/ or bleeding from the back passage.

Glanville’s case was especially severe in that an abscess had formed on one of the diverticula and then burst, causing peritonitis. She was treated with intravenous antibiotics and underwent keyhole surgery which enabled the poison to be drained away. Surgeons managed to repair the affected diverticula by stitching it, although if she has repeated bouts of diverticulitis, she may face surgery to remove the affected section of her colon.

Glanville, 69, a retired hospital ward clerk from Shrewsbury, now carries antibiotic tablets when she travels to stop a flare-up in its tracks.

She says: “I suffer from irritable bowel syndrome, as well as diverticular disease, but feel I can now recognise diverticulitis. I’ve had it again, which wasn’t as bad, but I know how quickly it can become serious and that’s frightening.”

To determine whether a patient has problems with diverticula, doctors usually carry out a CT colonography using a CT scanner to produce 3D images of the colon.

Lack of fibre is thought to be a key cause of diverticula developing in the first place. However, Geoff Hutchinson, a consultant surgeon and gastroenterologist at Spire Cheshire Hospital, Warrington, believes the pouches are more likely to be due to the natural ageing process in the bowel. Many of his patients find fibre can make problems worse and they learn what diet suits them through simple trial and error, he says.

“Much more research is needed into diverticular disease and diverticulitis. As the older population increases, this is potentially a massive problem but no one wants to take ownership of it.”

If you do have the condition, a healthy lifestyle and probiotics should help, he advises. And if you suspect you have it, warns Hutchinson, “don’t self-diagnose. Visit your GP as bowel cancer can cause similar symptoms”.

The sooner diverticulitis is treated with antibiotics, the lower the risk of complications developing.

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