I’ve changed my diet but my condition is still causing me discomfort
I’VE been diagnosed with a bowel condition, diverticulosis. Is there any treatment or cure, other than diet? The feeling of always needing to go to the toilet is causing a lot of discomfort.
ADIVERTICULUM is a pouch-like structure formed on the wall of the colon — ‘diverticulosis’ is where there are multiple diverticulae, anything from a scattered few to even hundreds of these bubble-like pouches.
Twenty per cent of people aged 40 will have a few diverticulae, and 60 per cent of those aged 60 will be affected, yet most people have no idea they have them as they remain symptom-free throughout life.
Problems occur, when, for example, the walls of one or more of the diverticulae become infected — this is then referred to as diverticulitis. This may be caused by increased pressure in the colon as a result of faecal debris becoming trapped.
The symptoms commonly include pain in the left lower abdomen, fever and upset bowel function — either constipation or diarrhoea.
About 10% of those with diverticulosis may develop urinary tract infections (UTIs) because of the proximity of the bladder to infected diverticulae — the large bowel nestles against the wall of the bladder and with the two surfaces in direct contact, one inflamed surface will stick to the other and transmit inflammation, even infection.
Such infections will normally settle with antibiotics, but at times an abscess may form in a pouch which may lead to peritonitis, an infection of the peritoneal cavity — the peritoneum is the membrane that lines the entire abdomen.
Blood may appear in the stools if an artery in the wall of a diverticulum is eroded — normally as a result of age. This occurs in between 5% and 10% of patients.
Once the diagnosis has been made there is no treatment that will get rid of these pouches.
Most doctors urge their patients to increase the fibre in the diet which softens stools and may help prevent the development of yet more diverticulae. Other measures such as antispasmodics and probiotic supplements may minimise symptoms and, hopefully, prevent complications.
Your symptom of constantly needing to empty the bowel is called tenesmus. This has a number of causes which include diverticulosis (as inflammation in the bowel wall can prompt muscle contractions) but also irritable bowel syndrome, inflammatory bowel disease (such as ulcerative colitis), colon infections and cancer.
I hope you’ve been fully investigated, with a sigmoidoscopy (when a viewing instrument is used to inspect the rectum and lowest part of the colon), or full colonoscopy (a visual inspection of the entire colon).
The possibility of two common conditions coexisting must be considered as tenesmus is not a regular feature of diverticulosis, which is most commonly symptom-free. So I would discuss your continued discomfort with your GP.