Ann Rheum Dis 63:588-590 doi:10.1136/ard.2003.010355
  • Concise report

Steroids, non-steroidal anti-inflammatory drugs, and sigmoid diverticular abscess perforation in rheumatic conditions

  1. S Mpofu1,
  2. C M A Mpofu2,
  3. D Hutchinson1,
  4. A E Maier3,
  5. S R Dodd4,
  6. R J Moots1
  1. 1Academic Rheumatology Unit, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK
  2. 2Gastroenterology Research group, Department of Medicine, University of Liverpool, Liverpool L69 3GA, UK
  3. 3Park Street Surgery, Merseyside, UK
  4. 4Centre for Medical Statistics and Health Evaluation, School of Health Sciences, University of Liverpool, Liverpool, UK
  1. 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.


  • 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.