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Use of acetaminophen and nonsteroidal anti-inflammatory drugs: a prospective study and the risk of symptomatic diverticular disease in men.
Arch Fam Med 1998 May-Jun; 7(3):255-60AF

Abstract

OBJECTIVE

To examine prospectively the relationship between self-reported regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen and the risk of symptomatic diverticular disease.

DESIGN

Prospective cohort study using a mailed baseline questionnaire in 1986, and follow-up every 2 years through 1992.

SETTING

Male health professionals residing in 50 US states.

PATIENTS

A total of 35 615 male health professionals (dentists, optometrists, veterinarians, physicians, pharmacists, osteopathic physicians, podiatrists) 40 to 75 years of age at baseline and free of diagnosed diverticular disease, colon or rectal polyp, ulcerative colitis, and cancer prior to 1988.

MAIN OUTCOME MEASURES

Follow-up questionnaires in 1988, 1990, and 1992 about use of NSAIDs, acetaminophen, and other variables including the diagnosis of symptomatic diverticular disease.

RESULTS

During 4 years of follow-up, we documented 310 newly diagnosed cases of symptomatic diverticular disease. After adjustment for age, physical activity, and energy-adjusted dietary fiber and total fat intake, regular and consistent use of NSAIDs and acetaminophen was positively associated with the overall risk of symptomatic diverticular disease (for users vs nonusers, relative risk [RR] for NSAIDs = 2.24, 95% confidence interval [CI], 1.28-3.91; RR for acetaminophen = 1.81, 95% CI, 0.79-4.11). Most of this positive association was attributable to cases associated with bleeding, particularly for acetaminophen (for users vs nonusers, RR for NSAIDs = 4.64, 95% CI, 0.99-21.74; RR for acetaminophen = 13.63, 95% CI, 3.53-52.60).

CONCLUSIONS

These results suggest that regular and consistent use of NSAIDs in general and acetaminophen is associated with symptoms of severe diverticular disease, particularly bleeding. Further research is needed to investigate the potentially deleterious effect of NSAIDs and other medications on the lower gastrointestinal tract.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, Boston, Mass, USA. walid.aldoori@whitehall-robins.on.cazNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9596460

Citation

Aldoori, W H., et al. "Use of Acetaminophen and Nonsteroidal Anti-inflammatory Drugs: a Prospective Study and the Risk of Symptomatic Diverticular Disease in Men." Archives of Family Medicine, vol. 7, no. 3, 1998, pp. 255-60.
Aldoori WH, Giovannucci EL, Rimm EB, et al. Use of acetaminophen and nonsteroidal anti-inflammatory drugs: a prospective study and the risk of symptomatic diverticular disease in men. Arch Fam Med. 1998;7(3):255-60.
Aldoori, W. H., Giovannucci, E. L., Rimm, E. B., Wing, A. L., & Willett, W. C. (1998). Use of acetaminophen and nonsteroidal anti-inflammatory drugs: a prospective study and the risk of symptomatic diverticular disease in men. Archives of Family Medicine, 7(3), pp. 255-60.
Aldoori WH, et al. Use of Acetaminophen and Nonsteroidal Anti-inflammatory Drugs: a Prospective Study and the Risk of Symptomatic Diverticular Disease in Men. Arch Fam Med. 1998;7(3):255-60. PubMed PMID: 9596460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of acetaminophen and nonsteroidal anti-inflammatory drugs: a prospective study and the risk of symptomatic diverticular disease in men. AU - Aldoori,W H, AU - Giovannucci,E L, AU - Rimm,E B, AU - Wing,A L, AU - Willett,W C, PY - 1998/5/22/pubmed PY - 1998/5/22/medline PY - 1998/5/22/entrez SP - 255 EP - 60 JF - Archives of family medicine JO - Arch Fam Med VL - 7 IS - 3 N2 - OBJECTIVE: To examine prospectively the relationship between self-reported regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen and the risk of symptomatic diverticular disease. DESIGN: Prospective cohort study using a mailed baseline questionnaire in 1986, and follow-up every 2 years through 1992. SETTING: Male health professionals residing in 50 US states. PATIENTS: A total of 35 615 male health professionals (dentists, optometrists, veterinarians, physicians, pharmacists, osteopathic physicians, podiatrists) 40 to 75 years of age at baseline and free of diagnosed diverticular disease, colon or rectal polyp, ulcerative colitis, and cancer prior to 1988. MAIN OUTCOME MEASURES: Follow-up questionnaires in 1988, 1990, and 1992 about use of NSAIDs, acetaminophen, and other variables including the diagnosis of symptomatic diverticular disease. RESULTS: During 4 years of follow-up, we documented 310 newly diagnosed cases of symptomatic diverticular disease. After adjustment for age, physical activity, and energy-adjusted dietary fiber and total fat intake, regular and consistent use of NSAIDs and acetaminophen was positively associated with the overall risk of symptomatic diverticular disease (for users vs nonusers, relative risk [RR] for NSAIDs = 2.24, 95% confidence interval [CI], 1.28-3.91; RR for acetaminophen = 1.81, 95% CI, 0.79-4.11). Most of this positive association was attributable to cases associated with bleeding, particularly for acetaminophen (for users vs nonusers, RR for NSAIDs = 4.64, 95% CI, 0.99-21.74; RR for acetaminophen = 13.63, 95% CI, 3.53-52.60). CONCLUSIONS: These results suggest that regular and consistent use of NSAIDs in general and acetaminophen is associated with symptoms of severe diverticular disease, particularly bleeding. Further research is needed to investigate the potentially deleterious effect of NSAIDs and other medications on the lower gastrointestinal tract. SN - 1063-3987 UR - https://www.unboundmedicine.com/medline/citation/9596460/Use_of_acetaminophen_and_nonsteroidal_anti_inflammatory_drugs:_a_prospective_study_and_the_risk_of_symptomatic_diverticular_disease_in_men_ L2 - https://ClinicalTrials.gov/search/term=9596460 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -