Raising awareness of colon disease

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By Jane Elliott Health reporter, BBC News During flare-ups Christine is confined to the house

When Christine Button was rushed into hospital with a burst abscess in her colon, doctors warned her that she would probably need a colostomy bag.

Christine was devastated. She was 53 and planning her wedding - thoughts of the bag, used to collect human waste, horrified her.

"I begged the surgeons not to fit me with a colostomy bag - they told me they would do their best - but I really didn't want to walk down the aisle with a bag."

Luckily a bag was avoided, but Savvas Papagrigoriadis, consultant colorectal surgeon, said others were not so fortunate and that many emergency admissions could have been avoided with better management.

Christine has diverticular disease, caused by an increase in pressure in the large part of the gut, which forces small parts of the gut lining outwards through surrounding muscles.

DIVERTICULAR DISEASE Diverticular disease is a condition affecting the large bowel or colon and is thought to be caused by eating too little fibre Over a lifetime, it is estimated the human gut digests more than 65 tonnes of food and drink. Much of this food will be low in fibre, putting the gut under strain

This causes the lining to form small balloon-like pouches called diverticula, which can rupture.

It is estimated that this condition causes 100,000 hospital admissions each year in the UK - up to 18,000 of these emergencies - and 1,000 deaths.

But despite the fact that so many people are affected, Mr Papagrigoriadis, the lead clinician for the treatment of diverticular disease at King's College Hospital, London, says the condition is still not widely recognised by either medics or patients.

King's is currently the only hospital in the country to offer a dedicated diverticular disease clinic.

In a bid to boost awareness, leading academics held their first major conference recently at the Royal Society of Medicine, in London, to look at how new research can help improve outcomes and diagnosis.

Mr Papagrigoriadis said that the disease had received little attention.

AVOIDING DIVERTICULAR DISEASE It is thought a healthy diet rich in fruits and vegetables, low in red meat, no smoking and exercise can help prevent it

"One of the problems is that it had been erroneously thought to be a disease of elderly people and the priorities of the elderly are low in our society, yet 15% with this condition are under 50.

"The awareness among GPs and patients is very low and it is desirable that there is better awareness so that, instead of having emergency admissions with a very sick patient with a perforated bowel, we can prevent this.

"A lot of the patients come to us very sick and need a major operation leading to a colostomy.

"But if it can be diagnosed early, there can be a prevention of the complications, with antibiotics or planned keyhole surgery."

Christine, from south London, said she wished her condition had been better handled.

She was diagnosed in 2002 whilst undergoing treatment for an unrelated problem, but it was not until her emergency admission to King's last year that she was given access to a dedicated clinic.

"To be honest, I didn't really know what diverticular disease was and thought it was no big deal.

"However, the symptoms I started to experience were very acute - I was experiencing horrendous pain in my lower left abdomen and down my left hand-side.

Endoscope view of the colon affected by diverticular disease. It causes sacs (in brown) to form and protrude from the colon wall.

"The pain, which went on for days, was worse than childbirth".

Christine also had prolonged periods of upset stomach, and lost two stone (12.7 kgs) over three months.

"It is not the sexiest of ailments to have. You know you can't go out of the house in case you need the loo.

"Diverticular disease is a very painful, unpleasant, debilitating and disruptive condition.

"When an attack occurs it can take weeks for things to settle down and for life to get back to normal.

"The pain is excruciating and your insides become so sore it hurts to walk. Consequently life in general gets put on hold until things have calmed down, and normality can be resumed. "

Christine still experiences symptoms and pain, but is able to self-manage her condition by eating healthily, trying to reduce stress and giving up smoking and taking a proton pump inhibitor (PPI) - drugs used to treat ulcers and severe stomach indigestion.

She said: "The important thing about diverticular disease is diagnosing the problem early, so increasing the chances of successful treatment. I was so fortunate to end up at King's."