The increase in incidence of colonic
diverticular bleeding is relative to an age-related rise in the incidence of
colonic diverticulosis and use of antithrombotic medication. However, risk factors related to the onset, recurrence, and prophylaxis have not been established. Therefore, we aimed to determine risk factors for the onset and recurrence of colonic
diverticular bleeding.An age- and sex-matched case-control study was performed to assess the risk factors for the onset of colonic
diverticular bleeding. The distribution of
diverticulosis, comorbidity, and medication were evaluated from medical records. We also assigned patients with a first-time bleeding into groups with and without rebleeding during follow-up to determine risk factors for recurrence.Bilateral
colonic diverticulosis, nonselective nonsteroidal anti-inflammatory drugs (
NSAIDs), low-dose
aspirin (LDA), and
anticoagulants were significant risk factors for the onset of colonic
diverticular bleeding on multivariate analysis. In contrast, the use of selective
cyclooxygenase-2 (COX-2) inhibitor was not a risk factor for the onset. The incidence of
bleeding in direct oral
anticoagulant and
warfarin users was not different between the 2 groups. The cumulative recurrence rate at 1 year was 15%. Recurrence rate was significantly higher in patients with a prior history of colonic
diverticular bleeding than those without.
Steroid use was associated with recurrence.Extensive distribution of
diverticulosis and use of nonselective
NSAIDs, LDA, and
anticoagulants are regarded as risk factors for the onset of colonic
diverticular bleeding. In addition, a prior history of colonic
diverticular bleeding is related to the recurrence.