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Diverticular disease This leaflet aims to give an overview of diverticular disease and some of its treatments. Diverticula are small pouches that form in the wall of the large intestine (bowel). They are very common in people over 60 years of age. The exact cause is unknown but patients with the disorder often have abnormal muscle action in their large bowel plus abnormal movement of their bowels. In some cases the bowel wall becomes permanently thickened, which may result in recurrent constipation and pain in the lower abdomen. A diverticulum may be the site of inflammation which gives rise to more severe pain and tenderness over the area involved. In these circumstances a mild fever often occurs. This is diverticulitis. Occasionally a diverticulum may bleed, which results in blood being passed from the back passage. The diagnosis is confirmed by a barium enema X-ray examination. When pain is the main problem this can be relieved by drugs to relieve the spasms which cause the pain. These are prescribed by your doctor. If inflammation is present antibiotics will be prescribed. Whenever pain is severe you should immediately stop all solid food and take only fluids for a few days. If the symptoms do not respond to this treatment admission to hospital is occasionally necessary. Only very rarely is an operation required. Diverticular disease is not related to cancer. If constipation is a major symptom increasing the fibre content of your diet may be helpful. Fibre and bowel function Fibre is a complex mixture of plant substances which we do not digest or absorb. It is very necessary for the proper working of the intestine. It acts by passing unchanged through the intestine where it absorbs water, increases the bulk of undigested food and helps muscles in their important function of pushing the food residue along the intestines. This helps prevent constipation and straining. Many people in the western world eat a diet which is lacking in fibre. This is because many foods are processed in such a way as to remove and destroy the fibre - e.g. white flour, where the fibre-rich outer layers are removed in the milling process. It is recommended that we all eat at least 5 portions of fruit and/or vegetables plus wholemeal bread and cereal every day to maintain good health. High fibre foods There are three main food sources of natural dietary fibre: Fruit, vegetables and nuts. Fibre from these foods is higher in the skin and peel. When following a high fibre diet, if possible always eat the skin and peel. Try to eat the food raw or only lightly cooked, as cooking breaks down the fibre. Medway Community Healthcare CIC providing services on behalf of the NHS Registered office: 5 Ambley Green, Bailey Drive, Gillingham, Kent ME8 0NJ Tel: 01634 382777 Registered in England and Wales, Company number: 07275637 Bran and wholegrain cereal. These are a more concentrated source of fibre. When following a high fibre diet, change to using wholemeal bread, wholemeal flour, brown rice and wholewheat breakfast cereal or bran breakfast cereal. Pulses. Try to include these in your diet daily. Use them in soups, stews and salads or as a vegetable. Pulses are peas, lentils, baked beans and beans such as butter, red kidney, haricot, black eye, aduke, crab eye, mung and soya. If you find it difficult to eat enough fibre from these sources unprocessed bran can be added to food as detailed below. Guidelines for using unprocessed bran The aim is for you to pass a stool of a soft consistency and without great effort as often as is normal for you. Bran can be bought at most health food stores, supermarkets and chemists. When increasing your intake of bran it may be better to introduce it slowly into your diet. You may experience some flatulence or wind at first, but this will only be temporary so do not stop taking bran because of it. You will find that the amount of bran necessary will depend on the quantity of fibre in the rest of your diet. Once you have found the correct dose of bran for you, continue to take this indefinitely unless directed otherwise by your doctor, dietitian, community nurse or continence advisor. When eating a high fibre diet you must drink at least the recommended daily amount of fluids - 1.5 litres (the equivalent of three and a half pints; or 5 mugs; or 8 cups). Fluids should be from a variety of sources. Who to contact if you have any questions about this information: Continence Care, Keystone, Gun Lane, Strood, Kent ME2 4UL Tel: 01634 719252 Customer care Please send any comments about Medway Community Healthcare services to: Customer care manager, Medway Community Healthcare 7-8 Ambley Green, Bailey Drive, Gillingham, Kent, ME8 0NJ p: 01634 382266 f: 01634 382700 [email protected] All contact will be treated confidentially. Sharing your information Your information will only be disclosed to those who have a genuine need to know and who agree to keep your information confidential. For your direct care we often share information with NHS hospitals and clinics, GPs and social care. Leaflet reference: MCH301 Medway Community Healthcare CIC providing services on behalf of the NHS Registered office: 5 Ambley Green, Bailey Drive, Gillingham, Kent ME8 0NJ Tel: 01634 382777 Registered in England and Wales, Company number: 07275637