Look inside the management of colonic diverticular rebleeding: a systematic review

被引：0

作者：

Carabotti, Marilia ^{[5
]}

Marasco, Giovanni ^{[1
,2
]}

Radaelli, Franco ^{[3
]}

Barbara, Giovanni ^{[1
,2
]}

Cuomo, Rosario ^{[4
]}

Annibale, Bruno ^{[5
]}

机构：

[1] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[2] Univ Bologna, IRCCS Azienda Osped, Bologna, Italy

[3] Valduce Hosp, Gastroenterol Dept, Como, Italy

[4] AORN St Anna & San Sebastiano, UOC Gastroenterol, Caserta, Italy

[5] Sapienza Univ Rome, St Andrea Hosp, Dept Med Surg Sci & Translat Med, via Grottarossa 1035-1039, I-00185 Rome, Italy

来源：

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY | 2025年 / 18卷

关键词：

anticoagulant treatment; antiplatelet treatment; diverticular disease; endoscopic management; RISK-FACTORS; RECURRENCE; MORTALITY; DRUGS; SEVERITY; EVENTS;

D O I：

10.1177/17562848251321695

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding in adults and carries a significant risk of recurrence. However, there are many uncertainties regarding the management of the prevention of diverticular rebleeding.Objectives: To review the current evidence on the potential role of lifestyle, pharmacological and endoscopic treatments and to discuss the unmet needs in the prevention of colonic diverticular rebleeding.Design: A systematic review.Data sources and methods: Based on the identified Patients-Interventions-Comparators-Outcomes questions, a detailed and comprehensive literature search was conducted, from inception to 12 January 2024, without language restriction, according to the modified Preferred Reporting Items for Systematic review and Meta-Analyses reporting guidelines.Results: We did not find any dietary or lifestyle interventions (fibre intake, smoking, physical activity, alcohol consumption, BMI) to prevent colonic diverticular rebleeding. We also did not find any interventional studies of specific pharmacological treatments (such as rifaximin, mesalazine or probiotics) to prevent diverticular rebleeding. Data comparing endoscopic and conservative approaches used during the index episode come from observational studies and show conflicting results. Finally, there is a paucity of data regarding the timing of resumption of antiplatelet and anticoagulant therapy after an episode of colonic diverticular bleeding, and this remains to be determined.Conclusion: This review highlights the paucity of data on the possible role of lifestyle, pharmacological and endoscopic treatments in the prevention of colonic diverticular rebleeding and advocates future studies aimed at finding effective therapeutic strategies.

引用

页数：14

共 48 条

[1] High risk stigmata and treatment strategy for acute lower gastrointestinal bleeding: a nationwide study in Japan [J].

Aoki, Tomonori ;

Sadashima, Eiji ;

Kobayashi, Katsumasa ;

Yamauchi, Atsushi ;

Yamada, Atsuo ;

Omori, Jun ;

Ikeya, Takashi ;

Aoyama, Taiki ;

Tominaga, Naoyuki ;

Sato, Yoshinori ;

Kishino, Takaaki ;

Ishii, Naoki ;

Sawada, Tsunaki ;

Murata, Masaki ;

Takao, Akinari ;

Mizukami, Kazuhiro ;

Kinjo, Ken ;

Fujimori, Shunji ;

Uotani, Takahiro ;

Fujita, Minoru ;

Sato, Hiroki ;

Hayakawa, Yoku ;

Fujishiro, Mitsuhiro ;

Kaise, Mitsuru ;

Nagata, Naoyoshi .

ENDOSCOPY, 2024, 56 (04) :291-301

[2] Etiopathogenetic Mechanisms in Diverticular Disease of the Colon [J].

Camilleri, Michael ;

Sandler, Robert S. ;

Peery, Anne F. .

CELLULAR AND MOLECULAR GASTROENTEROLOGY AND HEPATOLOGY, 2020, 9 (01) :15-32

[3] Recurrent bleeding and thrombotic events after resumption of oral anticoagulants following gastrointestinal bleeding: Communication from the ISTH SSC Subcommittee on Control of Anticoagulation [J].

Candeloro, Matteo ;

van Es, Nick ;

Cantor, Nathan ;

Schulman, Sam ;

Carrier, Marc ;

Ageno, Walter ;

Aibar, Jesus ;

Donadini, Marco Paolo ;

Bavalia, Roisin ;

Arsenault, Marie-Pier ;

Coppens, Michiel ;

Ferrante, Noemi ;

D'Addezio, Andrea ;

Sormani, Stefano ;

Porreca, Ettore ;

Di Nisio, Marcello .

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2021, 19 (10) :2618-2628

[4] Thromboembolic events, recurrent bleeding and mortality after resuming anticoagulant following gastrointestinal bleeding A meta-analysis [J].

Chai-Adisaksopha, Chatree ;

Hillis, Christopher ;

Monreal, Manuel ;

Witt, Daniel M. ;

Crowther, Mark .

THROMBOSIS AND HAEMOSTASIS, 2015, 114 (04) :819-825

[5] Risks of Bleeding Recurrence and Cardiovascular Events With Continued Aspirin Use After Lower Gastrointestinal Hemorrhage [J].

Chan, Francis K. L. ;

Ki, En-Ling Leung ;

Wong, Grace L. H. ;

Ching, Jessica Y. L. ;

Tse, Yee Kit ;

Au, Kim W. L. ;

Wu, Justin C. Y. ;

Ng, Siew C. .

GASTROENTEROLOGY, 2016, 151 (02) :271-277

[6]

Chen WC., BIOMED RES INT, V2014, P463767

[7] Risk factors for early re-bleeding and associated hospitalization in patients with colonic diverticular bleeding [J].

Fujino, Y. ;

Inoue, Y. ;

Onodera, M. ;

Kikuchi, S. ;

Endo, S. ;

Shozushima, T. ;

Suzuki, K. .

COLORECTAL DISEASE, 2013, 15 (08) :982-986

[8] Treatment strategies for reducing early and late recurrence of colonic diverticular bleeding based on stigmata of recent hemorrhage: a large multicenter study [J].

Gobinet-Suguro, Maya ;

Nagata, Naoyoshi ;

Kobayashi, Katsumasa ;

Yamauchi, Atsushi ;

Yamada, Atsuo ;

Omori, Jun ;

Ikeya, Takashi ;

Aoyama, Taiki ;

Tominaga, Naoyuki ;

Sato, Yoshinori ;

Kishino, Takaaki ;

Ishii, Naoki ;

Sawada, Tsunaki ;

Murata, Masaki ;

Takao, Akinari ;

Mizukami, Kazuhiro ;

Kinjo, Ken ;

Fujimori, Shunji ;

Uotani, Takahiro ;

Fujita, Minoru ;

Sato, Hiroki ;

Suzuki, Sho ;

Narasaka, Toshiaki ;

Hayasaka, Junnosuke ;

Funabiki, Tomohiro ;

Kinjo, Yuzuru ;

Mizuki, Akira ;

Kiyotoki, Shu ;

Mikami, Tatsuya ;

Gushima, Ryosuke ;

Fujii, Hiroyuki ;

Fuyuno, Yuta ;

Gunji, Naohiko ;

Toya, Yosuke ;

Narimatsu, Kazuyuki ;

Manabe, Noriaki ;

Nagaike, Koji ;

Kinjo, Tetsu ;

Sumida, Yorinobu ;

Funakoshi, Sadahiro ;

Kawagishi, Kana ;

Matsuhashi, Tamotsu ;

Komaki, Yuga ;

Miki, Kuniko ;

Watanabe, Kazuhiro ;

Uemura, Naomi ;

Itawa, Eri ;

Sugimoto, Mitushige ;

Fukuzawa, Masakatsu ;

Kawai, Takashi .

GASTROINTESTINAL ENDOSCOPY, 2022, 95 (06) :1210-+

[9] Risk factors of re-bleeding within a year in colonic diverticular bleeding patients [J].

Gonai, Takahiro ;

Toya, Yosuke ;

Kawasaki, Keisuke ;

Yanai, Shunichi ;

Akasaka, Risaburo ;

Nakamura, Shotaro ;

Matsumoto, Takayuki .

DEN OPEN, 2022, 2 (01)

[10] Risk factors for short-term re-bleeding in patients with colonic diverticular bleeding: a multicenter retrospective study [J].

Gonai, Takahiro ;

Toya, Yosuke ;

Kudara, Norihiko ;

Abe, Keinosuke ;

Sawaguchi, Sera ;

Fujiwara, Takao ;

Eizuka, Makoto ;

Miura, Manami ;

Urushikubo, Jun ;

Yamada, Shun ;

Yamaguchi, Satoko ;

Asakura, Kensuke ;

Orikasa, Shunsuke ;

Matsumoto, Takayuki .

SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 2022, 57 (06) :690-695

← 1 2 3 4 5 →