title: Statins and Lower Gastrointestinal Conditions: A Retrospective Cohort Study.
abstract: Several studies have reported constipation, abdominal pain, or diarrhea as common adverse events for statins. Statins are among the most commonly prescribed medications, and the impact on the prevalence of these conditions was rarely studied as main outcomes. The aim of this study is to determine if statin therapy is associated with constipation, abdominal pain, diarrhea, or colitis. This was a retrospective cohort study using a regional military health care data from October 1, 2003, to March 1, 2012. A propensity score-matched cohort of statin users and nonusers was created based on 82 variables. The primary analysis evaluated the odds ratios of the following diagnoses: constipation, ≥3 encounters for constipation; abdominal pain, ≥3 encounters for abdominal pain; diarrhea, ≥3 encounters for diarrhea; colitis, ≥3 encounters for colitis; and endoscopy of the lower gastrointestinal tract, ≥3 endoscopies of the lower gastrointestinal tract. After propensity score matching of 6342 statin users and 6342 nonusers, there was no statistically significant difference in constipation (OR, 0.96; 95%CI, 0.87-1.05; P = .33), abdominal pain (OR, 0.95; 95%CI, 0.88-1.02; P = .15), or colitis (OR, 1.02; 95%CI, 0.91-1.14; P = .73). However, there was an association between statin therapy and endoscopy of the lower gastrointestinal tract (OR, 1.14; 95%CI, 1.04-1.26; P = .002) and decreased odds of diarrhea (OR, 0.88; 95%CI, 0.80-0.97; P = .01). In this retrospective cohort study, an association between statin therapy and increased likelihood of being diagnosed with lower gastrointestinal conditions could not be demonstrated, contrary to some statins package inserts.
authors.affiliation: Division of Gastroenterology at University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Pearlman
authors.affiliation: Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Covin
authors.affiliation: Department of Gastroenterology, VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Schmidt
authors.affiliation: Medicine Services, VA North Texas Health Care System and Departments of Medicine and Clinical Sciences at University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mortensen
authors.affiliation: Medicine Services, VA North Texas Health Care System and Departments of Medicine and Clinical Sciences at University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Ishak A
authors.initials: IA
authors.lastname: Mansi
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D003092:Colitis / Q000453:epidemiology*; D003248:Constipation / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology*; D004724:Endoscopy; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: abdominal pain; colonoscopy; constipation; diarrhea; statins