In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 29, No. 10 ( 2014-10), p. 1786-1793
Abstract:
The effects of various medications on lower gastrointestinal tract remains unknown. Here, we investigated the effects of nonsteroidal anti‐inflammatory drugs ( NSAID s), low‐dose aspirin, and antiplatelet drugs associated with diverticular bleeding. Methods This prospective study involved patients with diverticulosis who underwent colonoscopy. Alcohol and smoking, medications, and C harlson comorbidity index and G astrointestinal S ymptom R ating S cale scores were assessed. The medications evaluated were nine kinds of NSAID s, two kinds of low‐dose aspirin, 10 kinds of nonaspirin antiplatelet drugs, three kinds of anticoagulants, acetaminophen, and corticosteroids. Adjusted odds ratios ( aOR ) were estimated by a logistic regression model. Results A total of 911 patients with non‐bleeding diverticula ( n = 758) and bleeding diverticula ( n = 153) were enrolled. Independent risk factors were alcohol consumption (light drinker, aOR 3.4; ≥ moderate drinker, aOR 3.3), smoking index (≥ 400, aOR 2.0), NSAID s ( aOR 4.6), low‐dose aspirin ( aOR 1.9), and nonaspirin antiplatelet drugs ( aOR 2.2). The drugs significantly associated with bleeding were loxoprofen ( aOR 5.0), diclofenac ( aOR 3.1), diclofenac suppository ( aOR 8.0), etodolac ( aOR 4.9), enteric‐coated aspirin ( aOR 3.9), buffered aspirin ( aOR 9.9), clopidogrel ( aOR 2.5), and cilostazol ( aOR 7.3). Dual therapy carried a higher risk than monotherapy (single NSAID , aOR 3.6, P 〈 0.01; dual, aOR 23, P 〈 0.01; single antiplatelet drug, aOR 2.0, P 〈 0.01; dual, aOR 4.1, P 〈 0.01). Conclusions Besides alcohol and smoking, NSAID s, low‐dose aspirin, and antiplatelet drugs are risk factors for diverticular bleeding. The magnitude of risk may differ between different kinds of NSAID s and antiplatelet drugs, and dual therapy with NSAID s or antiplatelet drugs increases the risk of bleeding.
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
DOI:
10.1111/jgh.2014.29.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2006782-3
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