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. 2016 Aug 6;7(3):440-6.
doi: 10.4292/wjgpt.v7.i3.440.

Increase in colonic diverticular hemorrhage and confounding factors

Ken Kinjo  1 , Toshiyuki Matsui  1 , Takashi Hisabe  1 , Hiroshi Ishihara  1 , Shinichiro Maki  1 , Kenta Chuman  1 , Akihiro Koga  1 , Kensei Ohtsu  1 , Noritaka Takatsu  1 , Fumihito Hirai  1 , Kenshi Yao  1 , Masakazu Washio  1
Affiliations

Increase in colonic diverticular hemorrhage and confounding factors

Ken Kinjo et al. World J Gastrointest Pharmacol Ther. .

Abstract

Aim: To classify changes over time in causes of lower gastrointestinal bleeding (LGIB) and to identify factors associated with changes in the incidence and characteristics of diverticular hemorrhage (DH).

Methods: A total of 1803 patients underwent colonoscopy for overt LGIB at our hospital from 1995 to 2013. Patients were divided into an early group (EG, 1995-2006, n = 828) and a late group (LG, 2007-2013, n = 975), and specific diseases were compared between groups. In addition, antithrombotic drug (ATD) use and nonsteroidal anti-inflammatory drug (NSAID) use were compared between patients with and without DH.

Results: Older patients (≥ 70 years old) and those with colonic DH were more frequent in LG than in EG (P < 0.01). Patients using ATDs as well as NSAIDs, male sex, obesity (body mass index ≥ 25 kg/m(2)), smoking, alcohol drinking, and arteriosclerotic diseases were more frequent in patients with DH than in those without.

Conclusion: Incidence of colonic DH seems to increase with aging of the population, and factors involved include use of ATDs and NSAIDs, male sex, obesity, smoking, alcohol drinking, and arteriosclerotic disease. These factors are of value in handling DH patients.

Keywords: Aging; Colonic diverticular hemorrhage; Increase of incidence; Lower gastrointestinal bleeding.

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Figures

Figure 1
Figure 1
Annual totals and changes over time in number of patients undergoing colonoscopy for overt lower gastrointestinal bleeding, requiring hospitalization, requiring transfusions, and using antithrombotic drugs and nonsteroidal anti-inflammatory drugs (1995 to 2013). The incidence of lower gastrointestinal bleeding (LGIB) started to increase rapidly in 2002-2003, associated with increases in the number of patients hospitalized, receiving blood transfusions, using antithrombotic drugs (ATDs), and using nonsteroidal anti-inflammatory drugs (NSAIDs).
Figure 2
Figure 2
Changes in the number of patients with colonic diverticular hemorrhage: Number of patients requiring hospitalization, requiring transfusion, and using antithrombotic drugs or nonsteroidal anti-inflammatory drugs (1995 to 2013). The number of patients with diverticular hemorrhage (DH) started to increase rapidly in 2003, and peaked in 2008. This was associated with an increase in the number of patients hospitalized, receiving blood transfusions, using antithrombotic drugs (ATDs), and using nonsteroidal anti-inflammatory drugs (NSAIDs).
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