Written by Chrystal Moulton, Staff Writer. Aspirin (RR=1.73) and non-aspirin NSAIDs (RR=2.24) are strongly associated with lower intestinal bleeding (p<0.05).
Diverticular bleeding occurs when pouches that form in the walls of the large intestine or colon (called diverticula) bleed, causing a substantial amount of blood to appear in the stool. Diverticular bleeding is the most common form of lower gastrointestinal bleeding accounting for 30-40% of bleeding episodes presented in the colon. Common risk factors associated with diverticular bleeding are obesity, hypertension, anticoagulants, diabetes mellitus, and heart disease caused by restricted blood flow. However, more recent studies are suggesting that non-steroidal anti-inflammatory drugs (NSAIDs) may also play a role in the occurrence of diverticular bleeding. In the current study, researchers conducted a meta-analysis in order to determine an association between NSAIDs and diverticular bleeding.
A literary search of all research on diverticular bleeding, aspirin, and NSAIDs was conducted and evaluated before inclusion into the study. A total of 232 research articles and reviews were found. Of these articles however, only six were worthy of inclusion into this study. Using the data provided by these articles researchers calculated the relative risk of diverticular bleeding with respect to NSAID use and aspirin.
Researchers found that almost all the studies reported a significant risk of diverticular bleeding associated with NSAID use. Analysis of all the results combined revealed a relative risk of 2.48 (p<0.05). Researchers also analyzed the relationship between NSAIDs not containing aspirin and aspirin separately in relation to the occurrence of diverticular bleeding. They also accounted for any diversity in the data. Results showed that both aspirin (RR=1.73, p<0.05) and non-aspirin NSAIDs (RR=2.24, p<0.05) were significantly associated with the incidence of diverticular bleeding.
In all, the research points to non-aspirin NSAIDs and aspirin as strongly and consistently associated with the incidence of diverticular bleeding.
Source: Yuhara, Hiroki, et al. “Aspirin and non-aspirin NSAIDs increase risk of colonic diverticular bleeding: a systematic review and meta-analysis.” Journal of gastroenterology 49.6 (2014): 992-1000.
© 2013, Springer Japan
Posted August 18, 2014.
Reference:
- Yuhara H, et al. Aspirin and non-aspirin NSAIDs increase risk of colonic diverticular bleeding: a systematic review and meta-analysis. J Gastroenterol. 2014 Jun;49(6):992-1000.
