Bachchanitis

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EVERYTHING Amitabh Bachchan does is news. When he’s afflicted with a tongue-twisting disease such as diverticulitis, it becomes the most commonly used word in the media. But experts say diverticulitis is rare in a developing country like India; it is more prevalent in industrialised nations where the diet is high in refined carbs and low in fibre. The disease emerged in the early 1900s, after the introduction of steel rolling mills, which reduced the fibre content of flour and other grains.

What is diverticulitis?
Commonly observed in people over 60, it involves the formation of small, bulging pouches (diverticula) in the digestive tract. Though diverticula can form anywhere—including the oesophagus, stomach and small intestine (as is the case with Bachchan)—they are usually spotted in the large intestine. Diverticulitis is the name given to the condition caused by infected diverticula.

‘‘Because these pouches seldom cause problems, you may never know you have them,’’ says Dr Anil Arora, senior gastroenterologist at Sir Ganga Ram Hospital, New Delhi.

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Why surgery?
In Bachchan’s case, one or more of the pouches became inflamed or infected, causing severe abdominal pain, fever and nausea. The infection is generally triggered by a bit of human waste that gets lodged in a pouch. ‘‘When the stool can’t exit the pouch, it increases the pressure, leading to the spread of infected material within the abdominal cavity, ’’ says Dr Arora.

How are the pouches formed?
The diverticula are formed when naturally weak points in the colon give way under pressure and form marble-sized pouches to protrude through the intestinal walls. ‘‘The condition could be congenital or may be sparked by a disease in the small or large intestine that pulls away the wall from the lumen (the open space of the intestine),’’ says Dr Arora. ‘‘The pouches are small to begin with, but can enlarge with time.’’

What are the signs?
Diverticulitis can feel like appendicitis, except the pain will be in the lower left side of the abdomen, instead of the lower right side. The pain is usually severe and comes on suddenly. Abdominal tenderness, fever, nausea and constipation are associated symptoms. Other signs include vomiting, bloating, rectal bleeding and difficult or painful urination.

THE FIRST TIME During the making of Mard in 1985, Bachchan was diagnosed with myasthenia gravis. It’s a common disorder of neuromuscular transmission, affecting specific muscles. In Bachchan’s case, it affected the muscles of his face, causing difficulties in chewing, swallowing and eating. Most patients reverse symptoms after drug therapy, but the treatment has to continue for life.

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Are there any risk factors?
While small intestinal diverticulitis is congenital and rare, colon diverticulitis has two risk factors:

Ageing With age, the outer muscular wall of the colon thickens, causing the inside passageway to narrow. The narrowing increases pressure on the colon and could encourage formation of pouches. Too little fibre Makes stools difficult to pass, which increase pressure in the colon.

What about the treatment?
Mild cases can be treated with rest, diet changes and antibiotics. But serious cases may require surgery to remove the diseased portion of the affected organ. ‘‘If the pouches rupture, the consequent leakage can result in sepsis or infection of the abdominal lining. Once the infection spreads, septicaemia—a fatal disease—can follow,’’ warns Dr Arora.

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