Whisper… it's my bowels


You know how balloons pop out into funny shapes if you blow hard enough? Your colon, or large intestine, is the same. Little pouches of the lining can get pushed out through the wall of the colon on to the outside - they're called diverticula. If you have them but don't get any symptoms, it's called diverticulosis. If they cause symptoms like bleeding from the bottom or crampy pain, you have diverticular disease. If they get inflamed and infected, it's diverticulitis (you also get inflammation in appendicitis, but in a different part of your bowel). Treatment may vary depending on which of these you have.

What causes diverticula?

The main cause is not eating enough fibre, and constipation. Your bowel muscles push food through your gut. The less bulk in your food, the harder they have to work and the higher the pressure. Diverticula get more common with age, because your colon has been under high pressure for longer.

What are the symptoms?

About three quarters of people who have diverticula get no symptoms. Other people get bloating or cramp-like low tummy pain which comes and goes and can be made better by opening their bowels. They can also cause diarrhoea and/or constipation, or passing mucus in the stools.

Diverticula are like little 'bubbles' with a narrow neck, and digested food can get trapped inside. Bacteria feed on this and multiply, causing local infection and inflammation - diverticulitis (the medical term for any inflammation is '-itis'). You'll feel 'infected' - feverish, tired and generally unwell - with constant pain in your lower tummy and sometimes, diarrhoea, constipation, blood in the stool or feeling or being sick.

Is it different from IBS?

IBS, or irritable bowel syndrome, can cause similar symptoms to diverticula. However, IBS tends to start in your 20s or 30s. Rarely, symptoms of bowel or ovarian cancer can also look a lot like diverticula or IBS. So if you get significant symptoms for the first time, your doctor may send you for tests such as a telescopic examination of your colon called a colonoscopy.

What's the treatment?

Fibre, fibre and more fibre are the key, to get your colon moving smoothly. It may seem obvious that making your bowel work less hard will help with pain and constipation, but oddly it can help with diarrhoea as well. It will also reduce the chance of getting a painful case of diverticulitis.

There are two main kinds of fibre - soluble and insoluble. Insoluble fibre is sometimes known as 'roughage' and is found in wholemeal and wholegrain foods and those with a high bran content, as well as in fruit and vegetables. 'Soluble' fibre is high in oats, rye bread, plums, bananas, peeled apples and pears and root vegetables. Some people find insoluble fibre makes pain and bloating worse, at least in the short term. If that's you, try swapping to soluble fibre. 'Fybogel' sachets (from your pharmacist or GP) also contain soluble fibre.

Treatment for diverticulitis depends on how severe your symptoms are, but includes antibiotics and painkillers.

How can I help myself?

Treating diverticula and diverticulosis is largely about changing your lifestyle. As well as increasing the fibre in your diet, making sure you drink enough fluids and get regular exercise will reduce the risk of flare-up of your symptoms. It may also give you more energy and improve your heart health - what's not to like?

Could it be something more serious?

Even if you've been diagnosed with diverticula, it's always worth seeing your doctor if your symptoms change. 'Red flags' that should send you to get checked out include:

  • Persistent bloating (which doesn't come and go) that's new for you
  • Blood in your stools or black, tarry stools
  • A change in bowel habit to looser or more frequent stools
  • Losing weight without meaning to, or being off your food
  • Severe pain, especially if you feel feverish and generally unwell.

With thanks to 'My Weekly' magazine where this article was originally published.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

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