Steroids, non-steroidal anti-inflammatory drugs, and sigmoid diverticular abscess perforation in rheumatic conditions.
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.
Mpofu
S
S
Academic Rheumatology Unit, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK. smpofu@liv.ac.uk
Mpofu
C M A
CM
Hutchinson
D
D
Maier
A E
AE
Dodd
S R
SR
Moots
R J
RJ
D000038:Abscess / Q000139:chemically induced*; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016001:Confidence Intervals; D004241:Diverticulum, Colon / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012216:Rheumatic Diseases / Q000188:drug therapy*; D012810:Sigmoid Diseases / Q000139:chemically induced*
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal