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Diverticular Disease

WHAT IS DIVERTICULAR DISEASE?

Diverticular disease of the colon is a common condition that afflicts about 50% of patients by age 60 years and nearly all by age 80 years. Despite this it is important to make it clear that only a small proportion of those with diverticula of the colon will get symptoms, and an even smaller proportion will need an operation for this problem.

Diverticula are pockets or pouches that develop through weaknesses in the colon wall.  It most often affects the sigmoid or left colon, but may involve the entire colon.   This condition can be described as wear and tear of the large bowel as these pouches increase in number as patients get older.

WHAT ARE THE SYMPTOMS?

As stated above many patients do not have symptoms or any problems from these abnormal pouches long the bowel.  Indeed they only exhibit symptoms if complications develop.  The major symptoms of diverticular disease are abdominal pain (usually in the lower left abdomen), diarrhoea, cramps, alteration of bowel habit and, occasionally, severe rectal bleeding.  These symptoms occur in a small percentage of patients with diverticulosis and are sometimes difficult to distinguish from other intestinal disorders such as irritable bowel syndrome or bowel cancer.

WHAT IS DIVERTICULITIS?

Diverticulitis describes an inflammation or infection of a diverticulum.  This may cause one or more of the following symptoms: pain, chills, fever, and change in bowel habits. Severe cases of diverticulitis may be complicated by severe infections in the abdomen such as peritonitis or abscesses, abnormal drainage tracts to the bladder or vagina (called fistula), or bursting of the colon requiring emergency operation.

WHAT IS THE CAUSE OF DIVERTICULAR DISEASE?

Research has suggested that a low-fibre diet over many years creates increased pressure within the colon.  This pressure then causes in the development of the bulges or diverticular pouches long the bowel wall at anatomical weak points in the bowel muscle wall.  The inner lining of the bowel is pushed through the weak areas similar to a pneumatic tyre inner tube could push through a weakness in a tyre wall.

HOW IS DIVERTICULAR DISEASE TREATED?

Mild symptoms of diverticular disease are usually treated by diet and occasionally medications to help control pain, cramps and changes in bowel habits.  Increasing the amount of dietary fibre (grains, legumes, vegetables, etc) and sometimes restricting certain foods reduces pressure in the colon so that complications are less likely to arise.

Diverticulitis requires more intense management. Diverticulitis is an inflammation of the colon which occurs in areas where diverticuli are present.  Mild cases may be managed without an admission to hospital.  Treatment would usually involve a course of oral antibiotics, and possibly stool softeners. Severe cases require hospitalization with intravenous antibiotics and strict dietary restraints. Many acute attacks can be relieved with such methods.

WHEN IS SURGERY NECESSARY?

Surgery is indicated for recurrent episodes, complications or severe attacks when there is little or no response to medication.  Surgery usually involves removal of the disease segment of bowel.  Commonly the left or sigmoid colon is removed and the colon is reconnected or "anastomosed" to the rectum. In some cases a stoma (an ileostomy or colostomy) may be needed which requires the patient to wear a bag.  Complete recovery can be expected. Normal bowel function usually resumes in 1 - 3 weeks.

WHO PERFORMS THIS TYPE OF SURGERY?

Colon and rectal surgeons are experts in the surgical and non surgical treatment of colon and rectal problems. They have completed advanced training in the treatment of colon and rectal problems in addition to full training in general surgery.

If you wish to arrange an appointment with Dr. Rob Church at Al Zahra Hospital Dubai

Contact Al Zahra Call Center on +971 4-378-6666