What is the outlook for diverticular disease?
Most people don’t even know that they have diverticulosis, because 80 per cent of people experience no symptoms. Often diverticula are picked up by chance during an investigation for another problem. For those who have diverticular disease, most will only have mild symptoms.
- The risk of having a large bleed is three to five per cent.
- The risk of surgery after the first attack of diverticulitis is 15 per cent.
- The risk of death during the first attack of diverticulitis is three per cent.
- After the first attack of diverticulitis, one in three will remain symptom free, one in three will have a future second attack and one in three will experience further mild symptoms.
- After a second attack of diverticulitis, only 10 per cent will remain symptom free.
- There is no evidence that diverticular disease can lead to bowel cancer.
New developments in the treatment of diverticular disease
- Mesalazine: there is some evidence to suggest that mesalazine, an anti-inflammatory drug used in inflammatory bowel disease to induce and maintain remission, reduces the duration of an attack of diverticulitis and it may even reduce the risk of recurrent attacks. This drug has been investigated in a number of studies and may reduce symptoms and help maintain a quiescent state. Further studies are required to establish its role.
- Probiotics: these are living microorganisms that exert health benefits by altering host microflora. Although there is no established role of probiotics in the management of diverticular disease, the theory is that they may be beneficial in restoring normal gut flora and stimulating the immune system, thereby reducing diverticular inflammation.
- Calcium channel blockers: a study in 2003 suggested that calcium channel blockers might reduce large bowel contractions and tone, hence protecting against perforation. However, further studies are needed to confirm this.
