Diverticulitis is a condition where parts of the bowel get inflamed or infected. The bowel is a muscular tube with a smooth wall that stool (poo) can pass along easily, helped by contractions of the gut muscles. As we age, our bowel can develop small outpouchings which are known as diverticula, and we think this is likely to be due to not eating enough fibre in our diet. Diverticula are very common and become more common with increasing age. This means that in the UK, about half of all people have at least one large bowel diverticula by the age of 50, and by the age of 80, about 7 in 10 of people have them.
Around three-quarters of people with diverticula have no symptoms, and they cause no harm. However, if these pockets get inflamed or infected – typically because of poo becoming trapped in them - this is known as diverticulitis and about 1 in 5 of people with diverticula will experience this at some time. People with a sudden flare of diverticulitis will suffer from constant abdominal pain, usually in the left lower side, that comes and goes but is usually worse after eating, and gets better after passing wind or stool. Other symptoms include constipation or diarrhoea, mucus or blood in the stool, and a fever. You can become quite ill.
Diverticulitis is diagnosed by your doctor after examining you, or from what is seen on either a CT scan or a colonoscopy (a camera placed inside the back passage).
Occasionally, if you have no relevant symptoms or only mild tummy pain and occasional bleeding from the back passage, diverticula may be seen as an incidental finding if you have a scan for another reason, and this is of little significance.
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A high fibre diet can help reduce the possibility of developing diverticula in the first place. If you do develop diverticula, fibre can help to bulk up your stool to keep it moving along, reducing the chance of diverticulitis developing.
A high fibre diet can often ease symptoms. There are some high fibre supplements such as Fybogel available at pharmacies, which can help to increase the amount of soluble fibre in the diet, in addition to a well-balanced diet.
For pain relief, paracetamol can help. It’s less likely to cause stomach upset than anti-inflammatories such as aspirin or ibuprofen, and is unlikely to cause the constipation that codeine-based painkillers can.
If your attack of diverticulitis is relatively mild, you may need strong painkillers and a course of antibiotic tablets, prescribed by your doctor. For a severe or prolonged episode, you may require hospital admission to be given intravenous fluids and antibiotics, sometimes with painkilling injections too. If you need to stay in hospital, this is usually for a few days only.
Although uncommon, complications can occur with diverticulitis including the bowel becoming completely blocked (known as obstruction), an abscess forming in the affected area, a fistula (channel) developing to other abdominal organs, and – if the diverticula bursts – peritonitis, where there is a generalised abdominal infection. Surgery may be required to treat these complications.
If you have symptoms of diverticulitis, you should urgently see your doctor. Symptoms can include abdominal pain, especially pain in the left lower side, fever, a change in your bowel habit with either constipation or diarrhoea, and mucus or blood in your poo.
Even if you know you have diverticula, always discuss any change of symptoms with your doctor and any change in your bowel habit, unexplained weight loss, abdominal pain or blood and mucus in your poo should be discussed with your doctor urgently.
An attack of diverticulitis will usually leave you feeling too unwell for work.
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