When my dad, a man who once went decades between doctor’s visits, started visiting his GP for abdominal pain and bloating in 2010, the family knew it must really be bothering him.
Dad never wanted to burden the overstretched health service but found himself going back to the doctor repeatedly for almost two years with abdominal pain, accompanied by a change in bowel habit, including sudden attacks of diarrhoea.
He’d gotten the all-clear from his bowel screening test – ruling out cancer – so his doctor dismissed his symptoms as irritable bowel syndrome (IBS), with a tone implying that he was a time waster.
Recently retired, he should have been enjoying a life of leisure but was instead scared to veer too far from the loo and began skipping meals because he often felt worse after eating.
Then, the vomiting began. And it didn’t stop for three days. He couldn’t keep anything down, including his medication to control his diabetes and blood pressure.
At first, we thought it was norovirus, but when dad began writhing in agony, his temperature spiked, and he became delirious; we called 999. When paramedics arrived, they quickly administered morphine and rushed him to the hospital.
The emergency room doctors thought he might have a ruptured appendix or a bowel obstruction and sent him for urgent scans.
While we waited for answers, dad’s dehydrated body was pumped with fluids.
When his doctor looked at the scan results, it turned out dad’s ‘IBS’ was a complication of diverticular disease, an incredibly common condition where sacs or pouches (diverticula) form in the intestinal wall.
If the diverticula become inflamed or infected, it’s called diverticulitis. In dad’s case, an infected diverticulum split, spreading the infection to the lining of his abdomen, causing potentially lethal peritonitis. He was admitted to intensive care for close monitoring while he began IV antibiotics.
The doctor explained diverticular disease is often age related. As you age, the walls of your large intestine become weaker, and the pressure passing stools through your intestines can cause diverticula to form.
The condition is widespread, with the NHS stating that most people will have some diverticula by the time they’re 80 years old.
But as the condition is closely linked to lifestyle and diet (particularly a lack of dietary fibre), diverticular disease is also on the rise among younger people.
As a result, hospital admissions for the condition have increased significantly. A report published by the National Institute for Care and Excellent (NICE) in 2019 shows A&E admissions increased by 30 per cent in the previous five years.
Gastroenterologist Dr Sara Mesilhy, part of the medical team at Probiotic Review Girl, explains that although diverticular disease and diverticulitis aren’t life-threatening, they can lead to complications that may require urgent care.
“Diverticulitis may cause bleeding, urinary problems, an abscess or fistula to form, peritonitis, and a bowel obstruction. These may require hospital admission and in some cases, surgery,” Mesilhy said.
While waiting for dad’s health to improve, we wondered how doctors had missed the condition for so long.
At no point in the multiple visits to the GP had a colonoscopy been suggested, a simple test that would have spotted diverticular disease immediately.
Dad trusted the NHS and never wanted to cause a fuss. But, as he lay in the hospital bed looking gravely ill, I wished I had helped him push for tests.
Mesilhy says it’s common for diverticular disease to be misdiagnosed. With symptoms such as pain in the lower left side, constipation, diarrhoea and occasionally blood in the stool, it can mimic many other conditions, including IBS.
With diverticulitis, Mesilhy says to look out for “constant, severe abdominal pain, high temperature, mucus or blood in the stool, or bleeding from the rectum.”
Diverticulitis requires medical attention before it becomes an emergency and can often be treated by your GP.
After two days in intensive care and a further week in the hospital, dad was discharged with dietary recommendations, including upping his fibre content, cutting down on his beloved red meat and increasing his fluid intake. Fibre and fluid help soften stool, allowing it to move more quickly and easily through the colon.
Within a month of his hospital discharge, dad felt like a new person. His bowel movements were regular, he wasn’t constantly bloated or gassy, and he wasn’t in pain.
He found the most challenging part of the advice to drink more water, with his pre-hospital fluid intake made up entirely of black tea, but he soon got on board when he realised it was helping his gut.
Since his first hospital admission for diverticulitis, dad has had multiple flare-ups of the condition, with another five hospital admissions. Now the family have become more vigilant at spotting signs of a potential infection, and a call to the GP for oral antibiotics can help avoid the need for a hospital trip.
Although many of us will be affected by diverticular disease during our lifetime, a lack of public information and awareness about the condition means it’s often overlooked. You should seek medical advice if you are experiencing symptoms including pain, diarrhoea, bleeding and fever.
Dad was lucky his infection was caught in time; peritonitis can be fatal in a few days. Don’t be afraid to push back and advocate for yourself if you feel your health concerns are not being taken seriously – it might just save your life.