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Perforated colonic diverticular disease: the importance of NSAIDs, opioids, corticosteroids, and calcium channel blockers.
Int J Colorectal Dis. 2008 Dec; 23(12):1193-7.IJ

Abstract

PURPOSE

Perforated colonic diverticular disease is associated with a high rate of late sequel and mortality. The risk of colonic perforation may relate to intracolonic pressure and mucosal barrier function in the wall of diverticula. The use of substances affecting these parameters may therefore be associated with the risk of developing a perforation. The aim was to study the effect of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, calcium channel blockers, and antimuscarinics on perforation in diverticular disease.

MATERIALS AND METHODS

A review of 54 patients with colonic diverticular perforation-forming the case group-and 183 patients with verified colonic diverticular disease-forming the control group-was done. Patient characteristics and drug use was registered.

RESULTS

Case group and control group were comparable with respect to sex, age, and comorbidity. In multivariate analysis, the use of NSAIDs (OR 3.56; 95% CI 1.50-8.43), opioids (OR 4.51; 95% CI 1.67-12.18), and corticosteroids (OR 28.28; 95% CI 4.83-165.7) were significantly associated with perforated diverticular disease. Acetylsalicylic acid in cardiologic dose did not affect the rate of perforation (OR 0.66; 95% CI 0.27-1.61). The use of calcium channel blockers was associated with a reduced rate of diverticular complications (OR 0.14; 95% CI 0.02-0.95).

CONCLUSIONS

The administration of NSAIDs, opioids, and corticosteroids are associated with an increased risk of colonic diverticular perforation. Acetylsalicylic acid in cardiologic dose does not affect the risk of perforation. Calcium channel blockers are associated with a reduced risk of perforation.

Authors+Show Affiliations

Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18679693

Citation

Piekarek, Kristoffer, and Leif A. Israelsson. "Perforated Colonic Diverticular Disease: the Importance of NSAIDs, Opioids, Corticosteroids, and Calcium Channel Blockers." International Journal of Colorectal Disease, vol. 23, no. 12, 2008, pp. 1193-7.
Piekarek K, Israelsson LA. Perforated colonic diverticular disease: the importance of NSAIDs, opioids, corticosteroids, and calcium channel blockers. Int J Colorectal Dis. 2008;23(12):1193-7.
Piekarek, K., & Israelsson, L. A. (2008). Perforated colonic diverticular disease: the importance of NSAIDs, opioids, corticosteroids, and calcium channel blockers. International Journal of Colorectal Disease, 23(12), 1193-7. https://doi.org/10.1007/s00384-008-0555-4
Piekarek K, Israelsson LA. Perforated Colonic Diverticular Disease: the Importance of NSAIDs, Opioids, Corticosteroids, and Calcium Channel Blockers. Int J Colorectal Dis. 2008;23(12):1193-7. PubMed PMID: 18679693.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perforated colonic diverticular disease: the importance of NSAIDs, opioids, corticosteroids, and calcium channel blockers. AU - Piekarek,Kristoffer, AU - Israelsson,Leif A, Y1 - 2008/08/05/ PY - 2008/07/17/accepted PY - 2008/8/6/pubmed PY - 2009/2/27/medline PY - 2008/8/6/entrez SP - 1193 EP - 7 JF - International journal of colorectal disease JO - Int J Colorectal Dis VL - 23 IS - 12 N2 - PURPOSE: Perforated colonic diverticular disease is associated with a high rate of late sequel and mortality. The risk of colonic perforation may relate to intracolonic pressure and mucosal barrier function in the wall of diverticula. The use of substances affecting these parameters may therefore be associated with the risk of developing a perforation. The aim was to study the effect of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, calcium channel blockers, and antimuscarinics on perforation in diverticular disease. MATERIALS AND METHODS: A review of 54 patients with colonic diverticular perforation-forming the case group-and 183 patients with verified colonic diverticular disease-forming the control group-was done. Patient characteristics and drug use was registered. RESULTS: Case group and control group were comparable with respect to sex, age, and comorbidity. In multivariate analysis, the use of NSAIDs (OR 3.56; 95% CI 1.50-8.43), opioids (OR 4.51; 95% CI 1.67-12.18), and corticosteroids (OR 28.28; 95% CI 4.83-165.7) were significantly associated with perforated diverticular disease. Acetylsalicylic acid in cardiologic dose did not affect the rate of perforation (OR 0.66; 95% CI 0.27-1.61). The use of calcium channel blockers was associated with a reduced rate of diverticular complications (OR 0.14; 95% CI 0.02-0.95). CONCLUSIONS: The administration of NSAIDs, opioids, and corticosteroids are associated with an increased risk of colonic diverticular perforation. Acetylsalicylic acid in cardiologic dose does not affect the risk of perforation. Calcium channel blockers are associated with a reduced risk of perforation. SN - 0179-1958 UR - https://www.unboundmedicine.com/medline/citation/18679693/Perforated_colonic_diverticular_disease:_the_importance_of_NSAIDs_opioids_corticosteroids_and_calcium_channel_blockers_ L2 - https://doi.org/10.1007/s00384-008-0555-4 DB - PRIME DP - Unbound Medicine ER -