Archive for the ‘What Might Help’ Category

Expert Patient Programme

Tuesday, October 11th, 2011

Nearly two years ago I wrote to the Secretary of State for Health asking why diverticular disease (DD) was not included with all the other diseases in the National Service Framework (NSF) for long term conditions or the NSF for older people or the ‘Expert Patient’ initiative. The government thought that both NSFs should ensure that all older people receive improved services based around their own individual needs, and in this way DD may well be covered but not specifically. 

The Expert Patient initiative is a new approach to the management of chronic diseases. (more…)

The colon’s little helpers

Sunday, February 6th, 2011


A report in 2007 by doctors at Duke University USA (1) proposed that the appendix functioned as a safe house for beneficial bacteria in the human gut. Rather than assessing the significance of this proposal for human biology, news agencies and internet sites seemed more concerned with the creation v evolution argument. The appendix had previously thought to be a relic of evolution even though its structure suggested otherwise.

The authors were unaware that I had come to the same conclusion in 1999 (2). Their literature search had not picked this up. Their proposal was based on observations of bacteria and immune system activity in the film of mucus lining the appendix and colon. My conclusion followed the realisation of why there was a symbiotic relationship with bacteria in the colon (more…)

The water we drink

Thursday, October 28th, 2010


Seasoned British travellers are well aware that 30 to 50 % of their visits to developing countries and popular holiday areas are estimated to result in traveller’s diarrhoea. Known as Montezumas revenge, delhybelly etc, the episodes usually last no more than 2 or 3 days but can extend to weeks or months of illness. People from the UK have a higher incidence of diarrhoea than those travelling from other industrial nations. Toxin – producing strains of E. coli are the most common cause, contaminated food and water pass them into the gut and diarrhoea is the body’s response to get rid of the invading organism. Adults in areas of poor sanitation and hygiene develop resistance to such organisms, having survived their effects in childhood. This resistance persists on moving to another developing country. A study of expatriates in Nepal found that the incidence of diarrhoea began to fall after 3 months residence. (1) The body reacts to unfamiliar bacteria as well as those causing infection. Traveller’s diarrhoea can have a long term effect on the bowel (2) and may account for 1 in 10 cases of IBS. (3) The pockets in the colon with DD are an ideal breeding ground for bacteria, can traveller’s diarrhoea cause diverticulitis? (more…)

Migraine, the gut and diverticular disease

Tuesday, September 14th, 2010


What has migraine got to do with diverticular disease?”

That was the occasional response when DD sufferers were asked in a survey if they or any blood relative have/did have migraine. However, 42% of females and 29% of males had migraine themselves or a blood relative did. Some noted that they ‘used to have’ migraine. These figures are far higher than the 10% or so incidence of migraine expected at retirement ages. A survey of migraine sufferers in Ireland found that 51% had also been diagnosed with IBS. A survey of people with IBS found a 60% greater prevalence of migraine than in non-IBS controls (1). There was a frequent association between headache, including migraine, and gastrointestinal symptoms (acid reflux, diarrhoea, constipation and nausea) in a Norwegian report (2).

Patients who did not respond to a high fibre diet, who had a single, intermittent abdominal pain were investigated in Leeds (3). Symptoms and family history suggested that 49% of them might have abdominal migraine and 32% of these had typical migraine symptoms during the attack. Mulak (4) noted that migraine and IBS often coexist. (more…)

Keeping Moving

Thursday, August 26th, 2010

  African schoolchildren 33 English schoolboys 70

 This is not the result of a rugby match but the start of the revolution in the treatment of diverticular disease (DD) in the 1970s. The figures are the average times in hours for food to pass through the digestive system (1) a measurement known as ‘transit time’ The difference in the two figures was attributed to the amount of fibre in the children’s diets. Researchers then tested this theory in adults, for example, adding fibre to a standard diet of five healthy young men reduced the mean transit time from 2.4 days to 1.6 days(2). People with DD had very little fibre in their diets and long transit times (3) (this was the medical treatment at the time so this finding was not surprising) Thus the fibre theory of cause, prevention and treatment of DD was born and dietary fibre has become an institution which has spread throughout medical research. As Dr le Fanu pointed out (4) it has never been demonstrated that those who get diseases eat more or less fibre than those who don’t, nor has it been demonstrated that eating more fibre will prevent diseases.

 There is another way of reducing transit time. (more…)