Steroids, non-steroidal anti-inflammatory drugs, and sigmoid diverticular abscess perforation in rheumatic conditions
- 1Academic Rheumatology Unit, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK
- 2Gastroenterology Research group, Department of Medicine, University of Liverpool, Liverpool L69 3GA, UK
- 3Park Street Surgery, Merseyside, UK
- 4Centre for Medical Statistics and Health Evaluation, School of Health Sciences, University of Liverpool, Liverpool, UK
- Correspondence to:
Dr S Mpofu;
- Accepted 4 June 2003
Background: Corticosteroids and non-steroidal anti-inflammatory drugs are widely used for the treatment of rheumatic conditions, but their gastrointestinal damage significantly limits their use. Sigmoid diverticular abscess perforation (SDAP) is a very serious complication of diverticular disease.
Objective: To determine the aetiology of large bowel SDAP in rheumatic conditions.
Methods: 64 patients with SPAD and 320 controls from a similar geographical area and of similar socioeconomic status were studied.
Results: The results showed that independently of rheumatic diagnosis corticosteroid treatment is strongly associated with SDAP (OR 31.9 (95% CI 6.4 to 159.2; p<0.001), and non-steroidal anti-inflammatory drugs only weakly associated (OR 1.8 (95% CI 0.96 to 3.4); p = 0.069). A rheumatic diagnosis is also strongly associated with the development of SDAP (OR 3.5 (95% CI 1.9 to 6.7); p<0.001).
Conclusions: SDAP has serious implications for patients and consumes many healthcare resources. Patients and physicians should be warned of this potential complication.
- sigmoid diverticular abscess perforation
- non-steroidal anti-inflammatory drugs
- rheumatic disease
- NSAIDs, non-steroidal anti-inflammatory drugs
- RA, rheumatoid arthritis
- SDAP, sigmoid diverticular abscess perforation
This study was presented as a poster at the 65th Annual Scientific Meeting of the American College of Rheumatology, 10–15 November 2001, San Francisco, USA.