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Increased diverticular complications with nonsteriodal anti-inflammatory drugs and other medications: a systematic review and meta-analysis.
Colorectal Dis. 2014 Jun; 16(6):O189-96.CD

Abstract

AIM

Complications of colonic diverticula, perforation and bleeding are a source of morbidity and mortality. A variety of drugs have been implicated in these complications. We present a systemic review and meta-analysis of the literature to assess the importance of this relationship.

METHOD

A systematic review of articles in PubMed, Cochrane Reviews, Embase and Google Scholar was undertaken in February 2013. An initial literature search yielded 2916 results that were assessed for study design and topicality. Twenty-three articles were included in the review. A qualitative data synthesis was conducted using forest plots of studies comparing single medication with complications.

RESULTS

Individual studies demonstrated the odds of perforation and abscess formation with nonsteridal anti-inflammatory drugs (NSAIDs) (1.46-10.30), aspirin (0.66-2.40), steroids (2.17-31.90) and opioids (1.80-4.51) and the odds of bleeding with NSAIDs (2.01-12.60), paracetamol (0-3.75), aspirin (1.14-3.70) and steroids (0.57-5.40). Pooled data showed significantly increased odds of perforation and abscess formation with NSAIDs (OR = 2.49), steroids (OR = 9.08) and opioids (OR = 2.52). They also showed increased odds of diverticular bleeding from NSAIDs (OR = 2.69), aspirin (OR = 3.24) and calcium-channel blockers (OR = 2.50). Most studies did not describe the duration or dosage of medication used and did not systematically describe the severity of diverticular complications.

CONCLUSION

Various common medications are implicated in complications of diverticular disease.

Authors+Show Affiliations

Department of Colorectal Surgery, King's College Hospital, London, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

24320820

Citation

Kvasnovsky, C L., et al. "Increased Diverticular Complications With Nonsteriodal Anti-inflammatory Drugs and Other Medications: a Systematic Review and Meta-analysis." Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, vol. 16, no. 6, 2014, pp. O189-96.
Kvasnovsky CL, Papagrigoriadis S, Bjarnason I. Increased diverticular complications with nonsteriodal anti-inflammatory drugs and other medications: a systematic review and meta-analysis. Colorectal Dis. 2014;16(6):O189-96.
Kvasnovsky, C. L., Papagrigoriadis, S., & Bjarnason, I. (2014). Increased diverticular complications with nonsteriodal anti-inflammatory drugs and other medications: a systematic review and meta-analysis. Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 16(6), O189-96. https://doi.org/10.1111/codi.12516
Kvasnovsky CL, Papagrigoriadis S, Bjarnason I. Increased Diverticular Complications With Nonsteriodal Anti-inflammatory Drugs and Other Medications: a Systematic Review and Meta-analysis. Colorectal Dis. 2014;16(6):O189-96. PubMed PMID: 24320820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased diverticular complications with nonsteriodal anti-inflammatory drugs and other medications: a systematic review and meta-analysis. AU - Kvasnovsky,C L, AU - Papagrigoriadis,S, AU - Bjarnason,I, PY - 2013/09/04/received PY - 2013/10/11/accepted PY - 2013/12/11/entrez PY - 2013/12/11/pubmed PY - 2015/1/7/medline KW - Aspirin KW - Diverticular perforation KW - NSAIDs SP - O189 EP - 96 JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland JO - Colorectal Dis VL - 16 IS - 6 N2 - AIM: Complications of colonic diverticula, perforation and bleeding are a source of morbidity and mortality. A variety of drugs have been implicated in these complications. We present a systemic review and meta-analysis of the literature to assess the importance of this relationship. METHOD: A systematic review of articles in PubMed, Cochrane Reviews, Embase and Google Scholar was undertaken in February 2013. An initial literature search yielded 2916 results that were assessed for study design and topicality. Twenty-three articles were included in the review. A qualitative data synthesis was conducted using forest plots of studies comparing single medication with complications. RESULTS: Individual studies demonstrated the odds of perforation and abscess formation with nonsteridal anti-inflammatory drugs (NSAIDs) (1.46-10.30), aspirin (0.66-2.40), steroids (2.17-31.90) and opioids (1.80-4.51) and the odds of bleeding with NSAIDs (2.01-12.60), paracetamol (0-3.75), aspirin (1.14-3.70) and steroids (0.57-5.40). Pooled data showed significantly increased odds of perforation and abscess formation with NSAIDs (OR = 2.49), steroids (OR = 9.08) and opioids (OR = 2.52). They also showed increased odds of diverticular bleeding from NSAIDs (OR = 2.69), aspirin (OR = 3.24) and calcium-channel blockers (OR = 2.50). Most studies did not describe the duration or dosage of medication used and did not systematically describe the severity of diverticular complications. CONCLUSION: Various common medications are implicated in complications of diverticular disease. SN - 1463-1318 UR - https://www.unboundmedicine.com/medline/citation/24320820/Increased_diverticular_complications_with_nonsteriodal_anti_inflammatory_drugs_and_other_medications:_a_systematic_review_and_meta_analysis_ L2 - https://doi.org/10.1111/codi.12516 DB - PRIME DP - Unbound Medicine ER -