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Sbeit W, Khoury T, Kadah A, Asadi W, Shahin A, Lubany A, Safadi M, Haddad H, Abu Ahmad R, Abu El Hija S, Abboud R, Mahamid M, Pellicano R, Mari A. Proton Pump Inhibitor Use May Increase the Risk of Diverticulitis but Not It's Severity among Patients with Colonic Diverticulosis: A Multicenter Study. J Clin Med 2020; 9:2966. [PMID: 32937926 PMCID: PMC7565510 DOI: 10.3390/jcm9092966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
Colonic diverticular disease, especially diverticulitis constitutes a major cause of hospitalization and an economic burden in developed countries. Proton pump inhibitors (PPIs) are among the commonest drugs used to treat several diseases affecting the upper gastrointestinal tract. A few studies have reported that the use of Proton Pump Inhibitors PPIs caused dysbiosis. In this study, we searched for a relationship between PPI use and the onset and severity of diverticulitis in patients with colonic diverticulosis. In a retrospective study, patients who were hospitalized for documented diverticulitis were enrolled as cases and compared with a control group of patients with uncomplicated diverticulosis. Overall, 613 patients who had a diagnosis of diverticulosis were included in the study, 217 of whom had diverticulitis. After multivariate analysis, the non-modifiable risk factors associated with diverticulitis included: age (p < 0.0001), hypertension (p < 0.0001), chronic renal failure (p = 0.007), diabetes mellitus (p < 0.0001), and left colon location (p = 0.02). However, among the modifiable factors, only PPI use (p < 0.0001) showed a significant association. Advanced disease severity (according to Hinchey classification of diverticulitis stages II-IV) was associated with aspirin use (p = 0.0004) and pan-colonic location (p = 0.02). PPI use was the only modifiable factor significantly associated with diverticulitis, but not with its severity, among patients with diverticulosis. This observation should be confirmed in future multicenter prospective studies.
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Affiliation(s)
- Wisam Sbeit
- Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13100, Israel; (W.S.); (T.K.); (A.K.); (W.A.); (A.S.)
| | - Tawfik Khoury
- Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13100, Israel; (W.S.); (T.K.); (A.K.); (W.A.); (A.S.)
| | - Anas Kadah
- Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13100, Israel; (W.S.); (T.K.); (A.K.); (W.A.); (A.S.)
| | - Waseem Asadi
- Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13100, Israel; (W.S.); (T.K.); (A.K.); (W.A.); (A.S.)
| | - Amir Shahin
- Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13100, Israel; (W.S.); (T.K.); (A.K.); (W.A.); (A.S.)
| | - Ahmad Lubany
- Surgery Department, The Nazareth Hospital, EMMS, Nazareth 1613101, Israel; (A.L.); (M.S.); (H.H.); (R.A.A.); (S.A.E.H.); (R.A.)
| | - Mohammed Safadi
- Surgery Department, The Nazareth Hospital, EMMS, Nazareth 1613101, Israel; (A.L.); (M.S.); (H.H.); (R.A.A.); (S.A.E.H.); (R.A.)
| | - Haya Haddad
- Surgery Department, The Nazareth Hospital, EMMS, Nazareth 1613101, Israel; (A.L.); (M.S.); (H.H.); (R.A.A.); (S.A.E.H.); (R.A.)
| | - Ruba Abu Ahmad
- Surgery Department, The Nazareth Hospital, EMMS, Nazareth 1613101, Israel; (A.L.); (M.S.); (H.H.); (R.A.A.); (S.A.E.H.); (R.A.)
| | - Sami Abu El Hija
- Surgery Department, The Nazareth Hospital, EMMS, Nazareth 1613101, Israel; (A.L.); (M.S.); (H.H.); (R.A.A.); (S.A.E.H.); (R.A.)
| | - Rand Abboud
- Surgery Department, The Nazareth Hospital, EMMS, Nazareth 1613101, Israel; (A.L.); (M.S.); (H.H.); (R.A.A.); (S.A.E.H.); (R.A.)
| | - Mahmud Mahamid
- Faculty of Medicine, Hebrew University of Jerusalem, Department of Gastroenterology and Liver Diseases, Shaare Zedek Medical Center, Jerusalem 9103401, Israel;
| | | | - Amir Mari
- Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Faculty of medicine, Bar-Ilan University, Nazareth 1613101, Israel
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