Diverticular bleeding: are nonsteroidal anti-inflammatory drugs risk factors for hemorrhage and can colonoscopy predict outcome for patients?
Presence of a visible vessel or an adherent clot with active bleeding is a reliable marker for significant hemorrhage. Ulcerated diverticula are the cause of trivial bleeding, and presence of this endoscopic finding accurately predicts a benign clinical course. NSAID may be an important risk factor for diverticular bleeding. It is possible that combined exposure to NSAID and ASA results in more severe bleeding compared with use of NSAID alone.
These results suggest that downregulation of EGFR signaling by sulindac metabolites may occur, at least in part, by inhibiting activation and expression of EGFR. Inhibition of EGFR signaling may account for part of the growth inhibitory and chemopreventive effects of these compounds.