Association between use of proton pump inhibitors and occurrence of colon diverticulitis

AbstractBackgroundSome recent studies have described the adverse effects of proton pump inhibitors (PPIs). PPI use and colonic diverticulitis are both associated with bacterial enteric infection and translocation. The aim of this study was to assess the association between PPI use and colonic diverticulitis.MethodsWe conducted a population-based nested case-control study in part by use of data retrospectively collected from the National Health Insurance Research Database. Diverticulitis patients were identified using inpatient discharge records with International Classification of Diseases, Ninth Revision, Clinical Modification codes (562.11 and 562.13), and were recruited as the study cohort. The controls were matched to the study patients by age, sex, nonsteroidal anti-inflammatory drugs use, laxative use, and index date. The cumulative defined daily dose (DDD) was estimated as the sum of the dispensed DDD of any PPI. The adjusted odds ratio and 95% confidence interval (CI) were estimated using multiple logistic regression.ResultsWe enrolled 690 patients with acute diverticulitis, along with 2760 patients who comprised the control group. The adjusted odds ratios for the study cohort compared with PPI nonusers, after adjusting for possible confounders (including sex, age, comorbidities, and medication), were 1.29 (95% CI = 0.70–2.36) and 1.02 (95% CI = 0.59–1.76) for the group with cumulative PPI use ≥42 and ≥55 DDDs over an exposure period of 90 and 180 days, respectively, prior to the claimed date of hospitalization for colonic diverticulitis.ConclusionThe study showed that use of PPIs did not increase the risk of colon diverticulitis