This information is about diverticular disease in ADPKD. It is intended as a general guide.
As people age, it’s common for them to develop bulges in the lining of the colon (the large bowel). These are called diverticula (see picture). About 1 or 2 out of every 10 people aged 45 or older have them. Diverticula can form in other parts of the digestive system too.
Usually, diverticula don’t cause any symptoms. However, in about 1 in 4 people, they cause symptoms such as abdominal pain, feeling bloated, and constipation or diarrhoea.
Figure 1: Comparisson between a normal and a colon with diverticula
You may have heard that you’re more likely to develop diverticula if you have ADPKD. This may be true if you have ADPKD and you also have kidney failure (i.e. you’re having dialysis or have had a kidney transplant).
However, people with ADPKD who have functioning kidneys are thought to have the same chance of developing diverticular disease as people without ADPKD. In the UK, about half of all people aged 50 years have diverticula.
Like the general population, people with ADPKD are only tested for diverticular disease if they have symptoms. Screening is not routinely available. If you have tests for other bowel problems, these may spot diverticula. If you have symptoms such as bloating, constipation or diarrhoea, your GP may refer you for tests to find the cause. We explain these tests later.
Usually, diverticula don’t cause symptoms or need treatment. However, if you have ADPKD and kidney failure, you could be more likely to get symptoms and complications of diverticular disease. Complications can include infections (called diverticulitis), an abscess in the abdomen, sudden bleeding, or a tear in your bowel, which would need treatment. In a study, 1 in 5 people with ADPKD who had received a kidney transplant developed a diverticulitis infection over a 12-year period.
Your doctor can explain symptoms to look out for and ways to reduce your risk of complications if you have diverticula.
If you need dialysis and have diverticular disease, your kidney specialist might suggest haemodialysis rather than peritoneal dialysis. Haemodialysis uses a machine to filter the blood, whereas peritoneal dialysis uses fluid placed in your abdomen. It is thought that using peritoneal dialysis if you have diverticular disease might increase your chance of developing fluid on the lung or having a hernia. Many people with diverticula can still have peritoneal dialysis though. The decision of which type of dialysis to have is based on many factors, including what you would find most convenient.
Diverticula can be found using:
There is no ‘simple fix’ for diverticular disease, but changes to diet and medications can help.
Treatment depends on symptoms:
It is not known why diverticular disease is more common in people with ADPKD and kidney failure. One suggestion is that the gene faults that cause ADPKD can also cause the muscle of the bowel wall to be weaker. Another idea is that the ‘glue’ that holds cells together (the extracellular matrix) is abnormal in the bowel of people with ADPKD].
Click on the links below for more information from the PKD Charity on related topics:
Click on the websites below to get information and support from other organizations:
Written by Hannah Bridges, PhD, independent medical writer, HB Health Comms Limited.
With thanks to all those affected by ADPKD who contributed to this publication.
Contact us for the version of this factsheet with scientific references.
Ref No: ADPKD.DIV.V1.3
© PKD Charity 2019
Due to be medically reviewed 2022
Disclaimer: This information is primarily for people in the UK. We have made every effort to ensure that the information we provide is correct and up to date. However, it is not a substitute for professional medical advice or a medical examination. We do not promote or recommend any treatment. We do not accept liability for any errors or omissions. Medical information, the law and government regulations change rapidly, so always consult your GP, pharmacist or other medical professional if you have any concerns or before starting any new treatment.
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