Diverticular disease
Rethink indicated for diverticular disease
From Dr M. Griffiths, MRPharmS
The keynote address by Professor Tom Kirkwood at the British Pharmaceutical
Conference (PJ, 5 October, p488) presented the equation that recognition
as a specific disease equals a decrease in stigma, increased recognition
of carers, the prospect of a cure, more research and increased interest
from the pharmaceutical industry. Alzheimer’s disease was the example
used.
I wonder if Professor Kirkwood realises that for another disease, which
affects 50 per cent of people in the same age group, the equation is in
reverse.
There is no “cure” for colonic diverticular disease, research
is minimal in this country and interest from the pharmaceutical industry
is negligible. The disease is recognised but the effects on patients’
lives are not. The dietary fibre theory on the cause, prevention and treatment
of diverticular disease cannot be sustained by closer examination1 or
by 30 years experience,2 nor can it be supported by changing epidemiology,
which has, however, always indicated an environmental cause.
A rethink is definitely indicated, but patients are now being told that
diverticular disease is an inevitable and normal part of ageing and that
because so many people are afflicted, it is questionable whether it should
be called a disease (meeting of the Digestive Disorders Foundation, June
2000).
A number of problem attitudes towards ageing were mentioned during the
Conference keynote address. I would suggest that diverticular disease
is a good example of this and changes are needed with some urgency in
these supposedly enlightened times.
Mary Griffiths
Macclesfield
References
1. J Simpson, R Spiller. Colonic diverticular disease. Clin Evidence:
Issue 5; June 2001.
2. Beyond Burkitt — is diverticular disease more than just cereal
fibre deficiency? Postgrad Med J 2000;76:257–8.
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