|
1
|
An J, Wu K, Wu T, Xu P, Yang C, Fan Y, Li Q, Dong X. Assessing the association between drug use and ischaemic colitis: a retrospective pharmacovigilance study using FDA Adverse Event data. BMJ Open 2025; 15:e088512. [PMID: 40398943 PMCID: PMC12097096 DOI: 10.1136/bmjopen-2024-088512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 04/30/2025] [Indexed: 05/23/2025] Open
Abstract
OBJECTIVE Drug-induced ischaemic colitis is a significant adverse event (AE) in clinical practice. This study aimed to recognise the top drugs associated with the risk of ischaemic colitis based on the FDA Adverse Event Reporting System (FAERS) database. DESIGN A cross-sectional design. SETTING All data retrieved from the FAERS database from the first quarter of 2004 to the fourth quarter of 2023. PARTICIPANTS A total of 5664 drug-induced ischaemic colitis AEs eligible for screening. PRIMARY AND SECONDARY OUTCOME MEASURES The Medical Dictionary for Regulatory Activities was used to identify ischaemic colitis (code: 10009895) cases. Disproportionality analysis for drug-associated ischaemic colitis signals. RESULTS Drug-induced ischaemic colitis AEs were more prevalent in females (60.12%) and individuals aged ≥65 years (34.25%). The common outcomes were hospitalisation (46.85%) and death (9.73%). Disproportionality analysis identified 91 ischaemic colitis signals and the top 30 drugs mainly involved in the gastrointestinal and nervous systems. The top five drugs with the highest reported OR, proportional reporting ratio, information component and the empirical Bayesian geometric mean, were alosetron, tegaserod, osmoprep, naratriptan and kayexalate. Additionally, 20 of the top 30 drugs did not have ischaemic colitis risk indicated in the package insert. CONCLUSIONS This study identified key drugs associated with ischaemic colitis, particularly alosetron, tegaserod, osmoprep, naratriptan and kayexalate. Notably, two-thirds of these drugs lacked ischaemic colitis warnings in their package inserts. These findings underscore the need for greater clinical vigilance, improved regulatory oversight and further research to clarify underlying mechanisms and support safer medication use.
Collapse
Affiliation(s)
- Jie An
- Department of General Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Kaiqi Wu
- Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Teng Wu
- Department of General Surgery, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Pengyang Xu
- Department of General Surgery, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chuanli Yang
- Department of General Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
- Southeast University, Nanjing, Jiangsu, China
| | - Yunhe Fan
- Department of General Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Qing Li
- Department of Pharmacy, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiushan Dong
- Department of General Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| |
Collapse
|
|
2
|
Vodusek Z, Feuerstadt P, Brandt LJ. Review article: the pharmacological causes of colon ischaemia. Aliment Pharmacol Ther 2019; 49:51-63. [PMID: 30467871 DOI: 10.1111/apt.15052] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/05/2018] [Accepted: 10/18/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Colon ischaemia is the most common ischaemic disorder of the gastrointestinal system, can affect any segment of the colon, and may present with a range of symptoms. Diagnosis can be challenging due to symptom overlap with other conditions, varied aetiology, and often rapid and self-resolving course. AIM To review comprehensively the literature regarding the pharmacological aetiologies of colonic ischaemia to enhance the understanding of the various mechanisms of disease, presentations, distribution, and outcomes. METHODS A PubMed search for "colon ischaemia" and "ischaemic colitis" alone as well as in combination with various known pharmacologic causes was performed. Only the highest quality and relevant literature was included in this review. The quality of the literature for each association was rated by the authors and a consensus was made when discrepancies were encountered. Only associations that were deemed "moderate" or "strong" were included. RESULTS The literature considering pharmacologically associated colonic ischaemia is diverse, lacks codification and is characterised by numerous case reports and case series. Constipation-inducing drugs, digoxin, hormonal therapies, illicit drugs, immunomodulators, laxatives, and NSAIDs were strongly associated with colonic ischaemia. Antimicrobials, appetite suppressants, chemotherapies, decongestants, diuretics, ergot alkaloids, serotonin agents, statins, and vasopressor agents were moderately associated. CONCLUSIONS Patients presenting with abdominal pain, diarrhoea, or bloody stool need to be evaluated for the possibility of this condition and treated accordingly. Timely diagnosis is necessary to improve patient outcomes. This review aims to increase awareness among clinicians regarding the presentation of pharmacologically induced colonic ischaemia.
Collapse
Affiliation(s)
- Ziga Vodusek
- Frank H. Netter, MD. School of Medicine, Quinnipiac University, North Haven, Connecticut
| | - Paul Feuerstadt
- Gastroenterology Center of Connecticut, Yale University School of Medicine, Hamden, Connecticut
| | - Lawrence J Brandt
- Division of Gastroenterology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| |
Collapse
|
|
3
|
Akbar A, Nissan G, Chaudhry P, Rangasamy P, Mudrovich S. Isolated naratriptan-associated ischemic colitis. Proc (Bayl Univ Med Cent) 2016; 29:410-411. [PMID: 27695179 DOI: 10.1080/08998280.2016.11929490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
We report a 41-year-old woman who developed histology- and colonoscopy-proven ischemic colitis with the use of naratriptan not exceeding the maximum 2 doses a day and 3 days per week and without a known medical or cardiovascular history. By exclusion of other causes of colonic ischemia, naratriptan was considered the sole causal agent. Discontinuation of naratriptan resulted in a complete clinical recovery. To date, our patient is the youngest known patient to develop ischemic colitis on isolated naratriptan in the setting of no known medical risk factors or predisposing medical condition. Even though triptans are commonly used for the abortive treatment of migraine headaches, such a reported side effect is rare; however, careful assessment and individual patient-based treatment is advised.
Collapse
Affiliation(s)
- Asra Akbar
- Departments of Headache Medicine (Akbar, Nissan, Chaudhry), Gastroenterology (Rangasamy), and Pathology (Mudrovich), Baylor Scott & White Health, Dallas, Texas. Dr. Akbar is now affiliated with the Department of Pediatric Neurology, University of Illinois College of Medicine, Peoria, Illinois
| | - George Nissan
- Departments of Headache Medicine (Akbar, Nissan, Chaudhry), Gastroenterology (Rangasamy), and Pathology (Mudrovich), Baylor Scott & White Health, Dallas, Texas. Dr. Akbar is now affiliated with the Department of Pediatric Neurology, University of Illinois College of Medicine, Peoria, Illinois
| | - Priyanka Chaudhry
- Departments of Headache Medicine (Akbar, Nissan, Chaudhry), Gastroenterology (Rangasamy), and Pathology (Mudrovich), Baylor Scott & White Health, Dallas, Texas. Dr. Akbar is now affiliated with the Department of Pediatric Neurology, University of Illinois College of Medicine, Peoria, Illinois
| | - Priya Rangasamy
- Departments of Headache Medicine (Akbar, Nissan, Chaudhry), Gastroenterology (Rangasamy), and Pathology (Mudrovich), Baylor Scott & White Health, Dallas, Texas. Dr. Akbar is now affiliated with the Department of Pediatric Neurology, University of Illinois College of Medicine, Peoria, Illinois
| | - Steven Mudrovich
- Departments of Headache Medicine (Akbar, Nissan, Chaudhry), Gastroenterology (Rangasamy), and Pathology (Mudrovich), Baylor Scott & White Health, Dallas, Texas. Dr. Akbar is now affiliated with the Department of Pediatric Neurology, University of Illinois College of Medicine, Peoria, Illinois
| |
Collapse
|
|
4
|
Hines DM, McGuiness CB, Schlienger RG, Makin C. Incidence of ischemic colitis in treated, commercially insured hypertensive adults: a cohort study of US health claims data. Am J Cardiovasc Drugs 2015; 15:135-49. [PMID: 25559045 DOI: 10.1007/s40256-014-0101-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Ischemic colitis (IC) incidence rates (IRs) among treated hypertensive patients are poorly understood, and existing literature on the subject is sparse. Antihypertensive drugs may raise the risk of developing IC. Novel antihypertensive agents—such as the direct renin inhibitor aliskiren—have not been assessed for IC risk. OBJECTIVES The aims of this study were to evaluate (1) the IRs of probable IC (pIC) in treated hypertensive adults, with a focus on aliskiren-treated patients; (2) the antihypertensive therapies used; and (3) the IRs of pIC in non-hypertensive adults. METHODS This study selected hypertensive and non-hypertensive patients (N = 2,356,226 each) from a US health plan claims database. pIC was defined as diagnosis of IC within 3 months after colonoscopy, recto-sigmoidoscopy, or colectomy. IRs were calculated per 100,000 person-years (PYs) with 95% confidence intervals (CIs) and stratified by antihypertensive regimen. RESULTS IRs of pIC in hypertensive and non-hypertensive subjects were 18.6 (95% CI 17.6-19.8) and 4.0 (95% CI 3.4-4.7), respectively. The non-hypertensive cohort consisted of younger patients who may have been less prone to developing IC. The overall (i.e., all antihypertensive regimens combined) monotherapy IR per 100,000 PYs was 17.5 (95% CI 16.2-18.8), the overall dual-combination regimen IR per 100,000 PYs was 19.5 (95% CI 17.37-21.83), and the overall triple-plus combination regimen IR per 100,000 PYs was 27.7 (95% CI 22.72-33.38). CONCLUSION Study results indicate that the treated hypertensive patients may have a higher risk of pIC compared with non-hypertensive populations. The quantity of antihypertensive agents prescribed may contribute to IC more than treatment duration.
Collapse
|
|
5
|
Manickam P, Jaurigue M, Batke M, Cappell MS. Recurrent ischemic colitis associated with oral contraceptive therapy. J Dig Dis 2014; 15:331-333. [PMID: 24612474 DOI: 10.1111/1751-2980.12139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Palaniappan Manickam
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA
| | | | | | | |
Collapse
|
|
6
|
Nguyen TQ, Lewis JH. Sumatriptan-Associated Ischemic Colitis: Case report and Review of the Literature and FAERS. Drug Saf 2014; 37:109-21. [DOI: 10.1007/s40264-013-0134-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
|
7
|
Tong K, Nicandro JP, Shringarpure R, Chuang E, Chang L. A 9-year evaluation of temporal trends in alosetron postmarketing safety under the risk management program. Therap Adv Gastroenterol 2013; 6:344-57. [PMID: 24003335 PMCID: PMC3756634 DOI: 10.1177/1756283x13491798] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Adverse events (AEs) of ischemic colitis (IC) and complications of constipation (CoC) associated with alosetron are rare and have been adjudicated during the first 5.5 years of the risk management program (RMP); however, changes in incidence rates relative to reductions in AE reports and increases in alosetron prescriptions over the 9-year RMP have not been evaluated. The authors aim to evaluate temporal trends in alosetron postmarketing safety over the 9-year RMP. METHODS The alosetron safety database was searched to identify cases of IC, CoC, and related AEs from 20 November 2002 to 31 December 2011. Adjudication of IC and CoC cases were based on US Food and Drug Administration-defined criteria. Incidence rates were calculated using the number of AEs and alosetron prescriptions (expressed as cases/1000 patient-years exposure). RESULTS A total of 29 cases were adjudicated as probable/possible IC and 7 cases were adjudicated as CoC. Cumulative adjudicated incidence rate of IC (1.03 cases/1000 patient-years) is low and stable, while that of CoC (0.25 cases/1000 patient-years) is low, declining progressively over time. Decreases in the incidence rates of potential symptoms of IC (abdominal pain with bloody diarrhea/hematochezia) and CoC (constipation) were also observed. CONCLUSIONS Over the 9-year RMP period, incidence rates of IC and CoC remain rare. Substantial reductions over time were observed in the incidence of CoC and in symptoms suggestive of IC or CoC, while IC incidence has been stable at approximately 1.0 case/1000 patient-years. Decreases in AEs and serious outcomes associated with IC and CoC since the reintroduction of alosetron are likely attributable to the RMP.
Collapse
|
|
8
|
Gergaud S, Lermite E, Butel F, Soltner C, Lasocki S. [Extensive mesenteric ischemia related to naratriptan overuse associated with grapefruit juice absorption]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2012; 31:472-474. [PMID: 22465646 DOI: 10.1016/j.annfar.2012.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 01/04/2012] [Indexed: 05/31/2023]
Abstract
We reported the case of a 61-year-old woman, who has been hospitalized in ICU because of an extensive mesenteric ischaemia, involving the small bowel, secondary to a naratriptan overuse. This mesenteric ischaemia was complicated by multiple organ failure and was responsible for extensive small bowel resection and left colectomy. A concomitant abundant absorption of grapefruit juice, a well-known P450 inhibitor, may have enhanced this naratriptan toxicity. This case underscore that an abdominal pain occurring in the context of headache treatment may be related to a mesenteric ischaemia.
Collapse
Affiliation(s)
- S Gergaud
- Pôle d'anesthésie-réanimation, université d'Angers, CHU d'Angers, 4, rue Larrey, 49000 Angers, France
| | | | | | | | | |
Collapse
|
|
9
|
Chang L, Tong K, Ameen V. Ischemic colitis and complications of constipation associated with the use of alosetron under a risk management plan: clinical characteristics, outcomes, and incidences. Am J Gastroenterol 2010; 105:866-75. [PMID: 20197759 DOI: 10.1038/ajg.2010.25] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Alosetron is a potent, selective 5-HT(3) receptor antagonist prescribed for women with severe diarrhea-predominant irritable bowel syndrome (IBS-D) under a risk management plan (RMP). The RMP was implemented following cases of ischemic colitis (IC) and complications of constipation (CoC) associated with the use of alosetron. The objectives of this study were to characterize IC and CoC clinical features, outcomes, and incidence rates in the new restricted patient population to evaluate the effectiveness of the RMP in the prevention of serious outcomes. METHODS Safety data from adverse event reporting from November 2002 through June 2008 were reviewed for probable and possible IC and CoC using the US Food and Drug Administration/sponsor-defined criteria and definitions. Evidence for IC included medical documentation, colonoscopy, and sigmoidoscopy+/-biopsy. Evidence for CoC included medical history and confirmation from health-care professionals. RESULTS Within the inclusion dates, 29,072 patients received 203,939 alosetron prescriptions. Although the absolute numbers of IC and CoC cases have declined, the incidence rates for IC and CoC (0.95 and 0.36 cases per 1,000 patient-years, respectively) were similar to rates during the postmarketing cycle before alosetron withdrawal. In patients with severe IBS-D receiving alosetron (n=998) or placebo (n=411) in clinical trials since reintroduction, incidence rates for IC were 4 and 2 cases per 1,000 patients, respectively. Rates for CoC were 2 and 0 cases per 1,000 patients in the alosetron and placebo groups, respectively. No mesenteric ischemia, surgeries, transfusions, or deaths occurred in patients with IC and no cases of CoC were associated with toxic megacolon, perforation, surgeries, transfusions, or deaths. IC and CoC cases were typically of short duration and all improved on prompt withdrawal of alosetron. CONCLUSIONS Serious outcomes associated with IC and CoC appear to be mitigated since introduction of alosetron under the RMP.
Collapse
Affiliation(s)
- Lin Chang
- Center for Neurobiology Stress, Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | | | | |
Collapse
|
|
10
|
Theodoropoulou A, Koutroubakis IE. Ischemic colitis: clinical practice in diagnosis and treatment. World J Gastroenterol 2009. [PMID: 19109863 DOI: 10.3748/wjg.v14.i46.7302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ischemic colitis is the most common form of ischemic injury of the gastrointestinal tract and can present either as an occlusive or a non-occlusive form. It accounts for 1 in 1000 hospitalizations but its incidence is underestimated because it often has a mild and transient nature. The etiology of ischemic colitis is multifactorial and the clinical presentation variable. The diagnosis is based on a combination of clinical suspicion, radiographic, endoscopic and histological findings. Therapy and outcome depends on the severity of the disease. Most cases of the non-gangrenous form are transient and resolve spontaneously without complications. On the other hand, high morbidity and mortality and urgent operative intervention are the hallmarks of gangrenous ischemic colitis.
Collapse
Affiliation(s)
- Angeliki Theodoropoulou
- Gastroenterology Unit Venizelion General Hospital of Heraklion, Heraklion 71110, Crete, Greece
| | | |
Collapse
|
|
11
|
|
|
12
|
Koutroubakis IE, Koutroubakis IE. Spectrum of non-inflammatory bowel disease and non-infectious colitis. World J Gastroenterol 2008; 14:7277-9. [PMID: 19109860 PMCID: PMC2778110 DOI: 10.3748/wjg.14.7277] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A variety of inflammatory diseases of the colon, which can be differentiated from inflammatory bowel disease (IBD) and infectious colitis by their clinical, endoscopic and histological characteristics, are reported as non-IBD and non-infectious colitis. These diseases include microscopic colitis, ischemic colitis, segmental colitis associated with diverticula, radiation colitis, diversion colitis, eosinophilic colitis and Behcet's colitis. The etiopathogenesis of most of these diseases remains obscure and the epidemiological data are rather limited. These conditions are often troublesome for the patient and are associated with diagnostic difficulties for the physician. In many cases the treatment is empirical and there is a need for future research using randomized controlled trials.
Collapse
|
|
13
|
Abstract
Ischemic colitis is the most common form of ischemic injury of the gastrointestinal tract and can present either as an occlusive or a non-occlusive form. It accounts for 1 in 1000 hospitalizations but its incidence is underestimated because it often has a mild and transient nature. The etiology of ischemic colitis is multifactorial and the clinical presentation variable. The diagnosis is based on a combination of clinical suspicion, radiographic, endoscopic and histological findings. Therapy and outcome depends on the severity of the disease. Most cases of the non-gangrenous form are transient and resolve spontaneously without complications. On the other hand, high morbidity and mortality and urgent operative intervention are the hallmarks of gangrenous ischemic colitis.
Collapse
|
|
14
|
Colon, Rectum, and Anus. Surgery 2008. [DOI: 10.1007/978-0-387-68113-9_52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
|
15
|
Abstract
Colon ischemia (CI) is the most common form of ischemic injury of the gastrointestinal tract. Determining the precise incidence of CI is a challenging task, because of its often brief, mild nature, and frequent spontaneous resolution, as well as its misdiagnosis as other diseases. While many underlying disease conditions may predispose patients to CI, an important and possibly overlooked etiology is that of pharmacologically induced alterations of colonic blood flow. This review details the pharmacologic agents known to be associated with CI; when possible, their mechanisms of action are described. The aim of this paper is to highlight this often unrecognized cause of CI, thereby helping physicians to be aware of the association, to recognize its occurrence promptly, and to possibly reduce morbidity and mortality.
Collapse
Affiliation(s)
- David J Hass
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA
| | | | | |
Collapse
|
|
16
|
Suh DC, Kahler KH, Choi IS, Shin H, Kralstein J, Shetzline M. Patients with irritable bowel syndrome or constipation have an increased risk for ischaemic colitis. Aliment Pharmacol Ther 2007; 25:681-92. [PMID: 17311601 DOI: 10.1111/j.1365-2036.2007.03250.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AIMS To estimate the relative risk for ischaemic colitis in patients with and without irritable bowel syndrome or constipation, and to evaluate the role of irritable bowel syndrome and constipation as confounders in the relationship between commonly used gastrointestinal medications and ischaemic colitis. METHODS Patient cohorts were identified with the use of longitudinal MarketScan research databases from 1 January 1999 to 31 December 2002. Patients in each study cohort were matched 1:1 with comparable control patients using a propensity score. A Cox proportional hazards models were used to estimate relative risk for ischaemic colitis. RESULTS The relative risk for ischaemic colitis was 3.17 and 2.78 times higher for patients with irritable bowel syndrome and constipation, respectively, than for those without these disorders. Patients who were taking an antispasmodic, a proton pump inhibitor, or an H2-antagonist were at increased risk for ischaemic colitis [relative risk with 95% CI 2.73 (1.41-5.39), 2.00 (1.05-3.79), 2.75 (1.22-6.17) respectively]; however, when these results were adjusted for irritable bowel syndrome or constipation, the relative risks were attenuated and no longer statistically significant. CONCLUSIONS Patients with irritable bowel syndrome or constipation demonstrated a two- to threefold increased risk for ischaemic colitis. Moreover, irritable bowel syndrome and constipation strongly confounded the relationship between gastrointestinal drug use and the risk for ischaemic colitis, suggesting that etiologic studies of ischaemic colitis risk must account for the presence of irritable bowel syndrome or constipation.
Collapse
Affiliation(s)
- D-C Suh
- College of Pharmacy, Rutgers University, Piscataway, NJ 08854, USA.
| | | | | | | | | | | |
Collapse
|
|
17
|
Matsumoto S, Tsuji K, Shirahama S. Clinical investigation of 41 patients with ischemic colitis accompanied by ulcer. World J Gastroenterol 2007; 13:1236-1239. [PMID: 17451205 PMCID: PMC4146999 DOI: 10.3748/wjg.v13.i8.1236] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 12/25/2006] [Accepted: 01/29/2007] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the relationship among the presence of ulcer lesions, underlying disease, and clinical course in patients with ischemic colitis. METHODS The subjects were 41 patients (10 male and 31 female; mean age 70 years) with ischemic colitis who were admitted to and received treatment in our hospital from 2000 to 2006. We compared their characteristics and analyzed the mean lengths of admission and fasting for 9 patients with ulcer lesions (ulcer group) and 32 without (non-ulcer group). RESULTS The groups with presence and absence of ulcer differed significantly only in white blood cell (WBC) count. Lengths of fasting and admission were 7.9 d and 17.9 d for the ulcer group and 4.4 d and 10.7 d for the non-ulcer group, respectively, and significantly longer in the ulcer group (P = 0.0057 and 0.0001). There was no correlation between presence of ulcer and presence of underlying diseases. CONCLUSION Lengths of fasting and admission were significantly longer in patients with ischemic colitis with ulcer than for those without ulcer.
Collapse
Affiliation(s)
- Satohiro Matsumoto
- Department of Internal Medicine, Kamigoto Hospital, 1549-11 Aokata-gou, Shinkamigoto-cho, Minamimatsuura-gun, Nagasaki 8574404, Japan.
| | | | | |
Collapse
|
|
18
|
Charles JA. 5-HT1B/1D Agonists, Oral Contraceptives, and Ischemic Colitis-A Response. Headache 2006. [DOI: 10.1111/j.1526-4610.2006.00474_4.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
|
19
|
Fox AW. 5-HT1B/1D Agonists, Oral Contraceptives, and Ischemic Colitis. Headache 2006; 46:1021-2; author reply 1022-3. [PMID: 16732852 DOI: 10.1111/j.1526-4610.2006.00474_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
|
20
|
Malone TD, Kori SH. Ischemic colitis associated with naratriptan and oral contraceptive use: a response. Headache 2005; 45:1418-9; author reply 1419-20. [PMID: 16324179 DOI: 10.1111/j.1526-4610.2005.00278_3.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
|
21
|
|
|
22
|
John Wiley & Sons, Ltd.. Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2005. [DOI: 10.1002/pds.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|