Diverticular bleeding of the colon and anticoagulant drugs

Background: In Japan in recent years colonic diverticular disease has increased, as has bleeding Secondary to diverticular disease. Methods: From July 1996 to November 2005, 332 patients with hematochezia had a colonoscopy, and 32 cases (9.6%) had colonic diverticular bleeding. The patients were evaluated in detail. Results: Of the 32 cases: 29 (90.6%) were more than 65 years old; 25 (78.1%) had diverticular bleeding located on the left side of the colon; 7 (21.9%) had bleeding on the right side of the colon; 26 (81.3%) had a blood clot that filled a diverticulum; 5 (15.6%) had bleeding that oozed; and 1 (3.1%) had bleeding that spurted. There were 30 cases (93.8%) with multiple diverticula of the colon and 2 cases (6.2%) with a single diverticulum of the colon. Furthermore, of the 32 cases: 26 (81.3%) were mild and did not need a blood transfusion; and 26 (81.3%) required no endoscopic treatment. The recent use of anticoagulant drugs was higher in patients with diverticular bleeding of the colon (50%) than in patients with other causes of hematochezia (10%). Conclusions: Most of the patients with diverticular bleeding were more than 65 years of age, and half of them were taking anticoagulant drugs. Thus, anticoagulant drugs may be one of the causes of colonic diverticular bleeding.