Division of Gastroenterology, NorthShore University HealthSystem, Evanston, IL, USA.
Rush University College of Nursing, Chicago, IL, USA.
BMC Gastroenterol. 2022 Jul 30;22(1):367. doi: 10.1186/s12876-022-02438-z.
Medication consumption has been suggested as a risk factor for microscopic colitis (MC), but studies of varying design have yielded inconsistent results. Our aim was to evaluate the association between medications and MC.
A hybrid cohort of prospectively identified patients undergoing colonoscopy with biopsies for suspicion of MC (N = 144) and patients with MC enrolled within three months of diagnosis into an MC registry (N = 59) were surveyed on medication use. Medication use was compared between patients with and without diagnosis of MC by chi-squared test and binomial logistic regression adjusted for known risk factors of MC: age and gender.
In total, 80 patients with MC (21 new, 59 registry) were enrolled. Patients with MC were more likely to be older (p = 0.03) and female (p = 0.01) compared to those without MC. Aspirin and other non-steroidal anti-inflammatory drugs were more commonly used among patients who developed MC (p < 0.01). After controlling for age and gender, these medications remained independent predictors of MC with odds ratio for any non-steroidal anti-inflammatory drug use of 3.04 (95% CI: 1.65-5.69). No association between MC and other previously implicated medications including proton pump inhibitors and selective serotonin reuptake inhibitors was found.
In this cohort of patients with chronic diarrhea, we found use of aspirin and non-steroidal anti-inflammatory drugs, but not other implicated medications to be associated with the development of MC. Whether these drugs trigger colonic inflammation in predisposed hosts or worsen diarrhea in undiagnosed patients is unclear. However, we feel that these findings are sufficient to discuss potential non-steroidal anti-inflammatory drug cessation in patients newly diagnosed with MC.
药物使用被认为是显微镜下结肠炎（MC）的一个风险因素，但不同设计的研究结果并不一致。我们的目的是评估药物与 MC 之间的关系。
前瞻性地对怀疑患有 MC 的结肠镜检查患者（N=144）和在诊断后三个月内纳入 MC 登记处的 MC 患者（N=59）进行了药物使用调查。采用卡方检验和二项逻辑回归比较了有和无 MC 诊断的患者之间的药物使用情况，并调整了 MC 的已知危险因素：年龄和性别。
共纳入 80 例 MC 患者（21 例新诊断，59 例登记）。与无 MC 的患者相比，MC 患者年龄更大（p=0.03），女性更多（p=0.01）。与未发生 MC 的患者相比，发生 MC 的患者更常使用阿司匹林和其他非甾体抗炎药（p<0.01）。在控制年龄和性别后，这些药物仍然是非甾体抗炎药使用的独立预测因素，其比值比为 3.04（95%可信区间：1.65-5.69）。未发现 MC 与质子泵抑制剂和选择性 5-羟色胺再摄取抑制剂等其他先前涉及的药物之间存在关联。
在本队列中，慢性腹泻患者使用阿司匹林和非甾体抗炎药与 MC 的发生相关，但未发现其他涉及的药物与 MC 相关。这些药物是否在易患宿主中引发结肠炎症或在未确诊的患者中加重腹泻尚不清楚。然而，我们认为这些发现足以讨论在新诊断为 MC 的患者中停止使用非甾体抗炎药的可能性。
