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[The risk factors for colonic diverticular bleeding]
Seungchul Suh1, Pyoung Ju Seo, Hyunkyung Park
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
Insights
Aspirin use and bilateral colonic diverticulosis are key risk factors for colonic diverticular bleeding. Patients taking aspirin or with diverticula in multiple colon locations require increased caution and education to mitigate bleeding risks.
Area of Science:
- Gastroenterology
- Internal Medicine
- Clinical Research
Context:
- Colonic diverticular bleeding constitutes a significant portion of lower gastrointestinal bleeding cases.
- Massive bleeding from diverticula occurs in 3-5% of cases, necessitating identification of risk factors.
Purpose:
- To evaluate risk factors associated with colonic diverticular bleeding.
- To identify predictors of bleeding in patients with colonic diverticulosis.
Summary:
- This study analyzed 216 patients with colonic diverticulosis, identifying 35 with diverticular bleeding.
- Older age, bilateral diverticulosis, atherosclerosis-related comorbidities, and use of aspirin, NSAIDs, and calcium channel blockers were associated with increased bleeding risk.
- Multivariate analysis revealed aspirin use and bilateral diverticulosis as independent risk factors for colonic diverticular bleeding.
Impact:
- Findings highlight the importance of considering aspirin use and the extent of diverticulosis in assessing bleeding risk.
- Emphasizes the need for patient education and caution, particularly for those with identified risk factors.
Background/Aims:
Colonic diverticular bleeding cases account for 30-40% of the lower gastrointestinal bleeding, among which, 3-5% appear to be massive bleeding. The purpose of this study was to evaluate the risk factors for colonic diverticular bleeding diagnosed by colonoscopic examination.
Methods:
Among the 1,003 patients, who were identified to have colonic diverticulosis including sleeding by diverticulitis and diverticular bleeding coding search, 216 patients had diverculosis, and they were divided into two groups: one with diverticular bleeding, and the other without bleeding. We evaluated the potential risk factors for diverticular bleeding, based on age, gender, location of diverticulum, comorbidities related to atherosclerosis, smoking, alcohol and medications, and compared them between both groups.
Results:
Among the 216 patients, we observed colonic diverticular bleeding in 35 patients (16.2%). The mean age of the bleeding group was significantly older than that of non-bleeding group. No difference was observed regarding gender ratio. Right colonic diverticula were common in both groups, but there were higher proportion of patients with bleeding in bilateral diverticuosis. Old age, bilateral diverticulosis, presence of atherosclerosis related diseases (hypertension, diabetes mellitus, ischemic heart disease, obesity), use of aspirin, NSAIDs and calcium channel blocker, increased the risk of bleeding. In a multivariate analysis, use of aspirin and bilateral diverticulosis were identified as independent risk factors for colonic diverticular bleeding.
Conclusions:
Since the patients who took aspirin and/or had bilateral colonic diverticulosis increased the risk of bleeding from divertuculi. As such, caution and education of patients are required.
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