CASES of a disease of the colon (large intestines) â€” diverticular disease â€” which was known to occur very rarely in Uganda until 2002, are increasing.
Dr. Sam Oola, a consultant at Mulago Hospitalâ€™s Radiology department, argued that it was due to the absence of technology that the disease could not be identified among Africans.
â€œA machine called a fluoroscopy for checking for the disease was introduced in Uganda in the 1980s,â€ Oola disclosed.
Elsie Kiguli and Henry Mukasa, physicians at the radiology department, carried out a six-year study and found that the disease existed in Uganda. The results were released in 2002.
A total of 31 patientsaged 40 years and above, were studied, after complaints of stomach aches and bleeding from the rectum.
Previously, a report by Dr. Ssali revealed eight cases in five years in Uganda. Kiguli and Mukasaâ€™s findings, therefore, show that the occurrence of the disease has increased.
â€œThe commonest presenting complaint was rectal bleeding in 13 patients, followed by abdominal pain (usually in the lower left abdomen) in 12 patients,â€ the findings read.
The colon is the last part of the large intestines that extracts water from the end products of digestion before they are passed out through the anus as faeces.
It is this part of the intestines whose walls (mucosal layer) develop an outgrowth of swellings, hence the initial stage of the diverticular disease.
In its initial stages, diverticular disease of the colon is referred to as diverticulosis, but if unattended, it deteriorates to another stage called diverticulitis.
Dr. Kenneth Opio, a physician at Mulago, explains that with diverticulosis, the symptoms are not as immediate as those of diverticulitis. â€œDiverticulosis can go years without symptoms.
But when they come, they include chronic constipation, diarrhoea and abdominal pain. With diverticulitis, there may be sudden abdominal pain associated with fever, chills, loss of appetite, nausea and vomiting,â€ Opio explained.
He further said those who lead inactive lifestyles are at high risk of developing the disease.
Though it is not genetically acquired, the disease is associated with aging and eating a low fibre diet.
â€œWith diverticulosis, we encourage a high fibre diet, exercises and taking iron and folate to replace your blood loss,â€ Opio explained.
Opio said as one grows older, the intestinal walls weaken and this may be aggravated by poor fibre intake, leading to diverticulitis.
Opio said the condition is common in urban areas where peopleâ€™s dietary habits are deficient of high fibre nutrients.
Vegetarians and those who consume large amounts of dietary fibre are least likely to be affected by diverticulosis. Foods high in fibre include vegetables, cereals and fruits.
According to the Africa Health Sciences journal of April 2002, it is argued that most Ugandans still eat the local diet and so, diverticulosis may not be associated with diet.
Dr. Ssali argued that the diet of the Ugandan middle class only differs from the traditional diet in its protein content in the form of meat, eggs, fish and milk.
Oola said despite the machine being temporarily out of service, they have been receiving two to three cases of diverticulosis per day.
Delayed treatment complicates oneâ€™s condition, he said.
â€œFood may collect in the out pouches (swellings) and get decayed, aggravating the condition. Complications of the disease include bleeding from the intestines, blockage of the intestines, pus collection in the swellings and perforation â€” the intestine tears, causing other internal infections.â€
In the primary stages of diverticular disease, it is usually treated by changes in diet and medication. The term â€˜diverticulaâ€™ refers to a swelling on the walls of the colon after the intestinal lining has become weak.
He further explained: â€œDiverticulitis tends to be more serious. We rest your bowels (fix a tube to artificially pass out feaces), give you intravenous fluids and pain killers. If you are bleeding and have recurrent bleeding, we may recommend surgery.â€
Opio disclosed that three out of 10 cases of diverticular disease, received at Mulago Hospital require surgery.
He emphasised that people who suspect they have the disease should first visit a physician for a check-up.
â€œBefore medication, a doctor always asks for an abdominal x-ray, a computer tomography or endoscopy, where the patient is taken for a scan.â€
Oola said: â€œAfter the doctor finds out the length of colon that has been affected, the surgeon decides whether to perform surgery or give medication.â€
Protect your intestines, stick to a fibre diet