Complications of diverticular disease and non-steroidal anti-inflammatory drugs: A prospective study

Abstract

Previous retrospective studies have suggested an association between consumption of non-steroidal anti-inflammatory drugs (NSAIDs) and the complications of diverticular disease. Ninety-two patients were entered into a prospective study of the complications of diverticular disease over a 3 year period; 31 were taking NSAIDs, compared with only four age- and sex-matched controls from a representative general practice (P less than 0.001). A second control group comprised 306 patients with cancer of the colon in whom NSAID consumption was again significantly lower than in patients with diverticular disease (22 of 306 versus 31 of 92, P less than 0.001). Of the 31 patients taking NSAIDs, 19 presented with a perforation or peritonitis. By contrast, only eight of the 61 patients not taking NSAIDs had such complications (P less than 0.001). Eleven patients presented with bleeding of whom five were taking NSAIDs and six were not. Patients admitted with complications of diverticular disease have a high incidence of NSAID intake, and it appears that NSAID consumption is associated with a more severe form of the disease.

An Herbal Medicine Orengedokuto Prevents Indomethacin-Induced Enteropathy

“…[8][9][10] Furthermore administration of NSAIDs may cause immediate relapse of quiescent intestinal bowel disease (IBD) and other diseases accompanying mucosal injuries. [11][12][13][14] Similar observations have been made in animal models. 15,16) Recently, although selective COX-2 inhibitors have been developed that were expected to produce less gastric injury, they retain the ability to cause bowel damage.…”

A guideline for the treatment and prevention of nsaid-induced ulcers

“…The incidence of these lesions has not been determined, especially in the United States where the use of NSAID suppositories is rare. NSAID-related complications have been reported in patients with pre-existing diverticulosis (116,117) and inflammatory bowel disease (119,120). In a controlled prospective study evaluating both complications of diverticulosis and perforation, it was found that 31 of 92 patients with complicated diverticular disease were taking NSAIDs, and this was significantly greater than the age-matched control group.…”

“…In a controlled prospective study evaluating both complications of diverticulosis and perforation, it was found that 31 of 92 patients with complicated diverticular disease were taking NSAIDs, and this was significantly greater than the age-matched control group. Nineteen of 31 patients taking NSAIDs had presented with perforation, whereas only 8 of 61 patients were non-NSAID users (p Ͻ 0.001) (116). Another case-controlled study of patients with severe complications of diverticulosis showed that 48% of these patients were taking NSAIDs when compared with matched controls (p Ͻ 0.01) (117).…”

Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly

“…Patients admitted with complications of diverticular disease have a high incidence of NSAID intake, and it appears that NSAID consumption is associated with a more severe form of the disease [12]. NSAIDS, opioid analgesics and corticosteroids are all positively associated with perforated colonic diverticular disease.…”