Common BP drug may lead to Diverticulosis in elderly

A team of scientists have found that blood pressure drug belonging to class of calcium channel blockers may lead to diverticulosis in elderly. 

Diverticulosis causes small bulges or pouches to appear in the lining of the intestine and can in some cases can lead to a medical emergency if the pouches become infected or burst.

High blood pressure affects onw in ten adults across the globe and increases the risk of heart attack and stroke. The most common treatments for high bP are lifestyle changes and medications.

A team of scientists incestigated the effectiveness and side effects of 3 common BP medications- ACE inhibitors, beta-bloackers and calcium channel blockers.

The 3 main medications which are being taken by millions were investigated and their potential side effects as well as studying their effectiveness for treating other diseases can be difficult and often involves lengthy and expensive clinical trials.

Therefore in order to overcome this problem, the research team used genetic analyses to study the effects of the drugs. By investigating versions of genes that mimic the effects of these drugs, the team were able to study the drugs' effectiveness and their potential side effects.

First, the researchers identified the proteins targeted by the drugs, and which helps lower BP. Next, they analysed genetic data from around 750,000 people and identifies the so-called genetic variants that code for these proteins.

The team, then studies whether these gene variants which cause increased production of these proteins, were linked to an increased or decreased risk of other diseases.

The good news was that, as expected, these so-called genetic variants ( which coded for proteins involved in lowering BP) were linked to lower heart disease and stroke risk.

However after assessing the risk of around 900 different diseases- using data from the study, the team found that the versions of genes related to the effects of a particular type of calcium channel blocker- the non-dihydropyridine class, were linked to an increased the risk of a bowel condition called diverticulosis.

The team compared their findings with further genetic data, and supported the potential link with an increased risk of the bowel condition.

The link now needs further investigation with larger trials, explains the co-lead author of the research. This is the first time that this class of BP drug has been associated with diverticulosis. We're not sure of the underlying mechanism- although it may relate to effects on the fiction of intestine muscles, which perform contractions to transport food through the gut.

Senior author added, the study of genetic variants that mimic the effect of drugs is evolving as a powerful concept to help prioritise clinical trials and design clinical trials more likely to be successful.

The researchers caution the findings should not change current prescribing guidelines and that people should not stop taking their medications unless first consulting their doctor.

He added, these findings should not change clinical practice, but instead should act as a catalyst for further research.

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Diverticulitis

What is diverticulitis?

Diverticulosis happens when pouches (diverticula ) form in the wall of the colon . If these pouches get inflamed or infected, it is called diverticulitis. Diverticulitis can be very painful.

What causes diverticulitis?

Doctors aren't sure what causes diverticula in the colon(diverticulosis). But they think that a low-fiber diet may play a role. Without fiber to add bulk to the stool, the colon has to work harder than normal to push the stool forward. The pressure from this may cause pouches to form in weak spots along the colon.

Diverticulitis happens when feces get trapped in the pouches (diverticula). This allows bacteria to grow in the pouches. This can lead to inflammation or infection.

What are the symptoms?

Symptoms of diverticulitis may last from a few hours to a week or more. Symptoms include:

• Stomach pain, usually in the lower left side, that is sometimes worse when you move. This is the most common symptom.
• Fever and chills.
• Bloating and gas.
• Diarrhea or constipation.
• Nausea and sometimes vomiting.
• Not feeling like eating.

How is diverticulitis diagnosed?

Your doctor will ask about your symptoms and will examine you. He or she may do tests to see if you have an infection or to make sure that you don't have other problems. Tests may include:

• Blood tests, such as a complete blood count (CBC).
• Other tests, such as an X-ray or a CT scan.

How is it treated?

The treatment you need depends on how bad your symptoms are and whether you have an infection. You may need to have only liquids at first, and then return to solid food when you start feeling better.

If you have an infection, your doctor may prescribe antibiotics. Take them as directed. Do not stop taking them just because you feel better.

For mild cramps and belly pain:

• Use a heating pad, set on low, on your belly.
• Relax. For example, try meditation or slow, deep breathing in a quiet room.
• Take medicine, such as acetaminophen (Tylenol, for example).

You may need surgery only if diverticulitis doesn't get better with other treatment, or if you have problems such as long-lasting (chronic) pain, a bowel obstruction, a fistula, or a pocket of infection (abscess).

How can you prevent diverticulitis?

You may be able to prevent diverticulitis if you drink plenty of water, get regular exercise, and eat a high-fiber diet. A high-fiber diet includes whole grains, fresh fruits, and vegetables.

Treatment

You may have a brief (acute) bout of diverticulitis that goes away after treatment with antibiotics and a liquid diet. But in some cases the condition occurs off and on (intermittently) over the long term (chronic). Treatment is the same in both cases, unless complications occur.

Initial treatment

Treatment for diverticulitis depends on how bad your symptoms are. If the pain is mild, you are able to drink liquids, and you have no signs of complications, treatment may include:

• Medicines such as antibiotics and pain relievers.
• Changes in diet, starting with a clear-liquid or bland diet that is low in fiber until the pain goes away, then increasing the amount of fiber.

Although some people avoid nuts, seeds, berries, and popcorn, believing that these foods might get trapped in the diverticula and cause pain, there is no evidence that they cause diverticulitis or make it worse.2

If the pain is severe, you are not able to drink liquids, or you have complications of diverticulitis, hospitalization is needed. Treatment will include:

• Antibiotics given in a vein (intravenous, or IV).
• Intravenous fluids and nutrition only (no food or drink by mouth) for up to a week to allow the bowel to rest.

Treatment may also include:

• Keeping the stomach empty by sucking out the contents through a tube passed up the nose and down the throat into the stomach (nasogastric or NG tube). This may be needed if you are vomiting or have abdominal swelling.
• Doing surgery either for complications of diverticulitis or if you have had repeated attacks that are not helped by changing your diet. Overall, fewer than 6 out of 100 people with diverticulitis need surgery.1

Most cases of promptly treated diverticulitis will improve in 2 to 3 days. If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better.

Ongoing treatment

Treatment after recovery from an attack of diverticulitis is aimed at preventing another attack. Treatment may include:

• Gradually increasing the amount of fiber in the diet through fruits, vegetables, wheat bran, and possibly the regular use of a fiber supplement.
• Getting plenty of fluids daily.
• Having regular doctor visits to monitor your condition. If you have diverticulitis, the doctor may see you about 2 days after treatment begins to make sure you are improving. A colonoscopy or barium enema X-ray probably will be done about 6 weeks later, after symptoms are under control, to look for any other problems, such as inflammatory bowel disease or colon cancer.

Treatment if the condition gets worse

In some cases, complications of diverticulitis, such as an abscess, perforation, or bowel obstruction, can occur. Surgery to remove the affected part of the intestine usually is needed to treat these conditions.

Non-urgent (elective) surgery also may be done for diverticulitis if you have had two or more severe attacks, are younger than age 40, or have an impaired immune system.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.

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