American University of Antigua, Saint John, Antigua and Barbuda
Sawai Singh Rathore, MBBS1, Tirath Daishikbhai Patel, MS2, Meghana Kakarla, MD3, Hairya Ajaykumar Lakhani, MBBS4, Bijay Mukesh Jeswani, MBBS5, Ujwala Reddy Borra, MBBS6, Hafiza Amna Qadeer, MBBS7, Ayesha Anam Syeda, MBBS8 1Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India; 2American University of Antigua, Osbourn, Saint John, Antigua and Barbuda; 3Infirmary Health, Mobile, AL; 4SBKS Medical Institute and Research Center, Vadodara, Gujarat, India; 5GCS Medical College, Hospital & Research Centre, Ahmedabad, Gujarat, India; 6MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India; 7Foundation University Medical College, Islamabad, Punjab, Pakistan; 8Dr VRK Women's Medical College, Hyderabad, Telangana, India
Introduction: Colonic diverticulosis is a prevalent condition marked by small pouches (diverticula) in the colon wall, particularly those over 50. Many studies have investigated various risk factors, but the relationship between smoking, alcohol consumption, and colonic diverticulosis remains to be determined. This meta-analysis analyses the association between these lifestyle factors and the risk of colonic diverticulosis and its complications.
Methods: A comprehensive literature search was conducted using PubMed, Embase, and Google Scholar to identify relevant studies. Inclusion criteria were based on predefined eligibility standards, focusing on observational studies reporting smoking, alcohol consumption, and colonic diverticulosis. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Statistical significance was set at p < 0.05. Egger's regression test and Begg-Mazumdar's rank test were used to assess publication bias. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).
Results: Sixty-two studies encompassing 32,54,5610 patients were included in the final analysis, where the mean age was 57.29 years, and 44.53% were female. Smoking increased the risk of colonic diverticulosis (OR 1.36, 95% CI: 1.24–1.48), diverticulitis (OR 1.59, 95% CI: 1.01 to 2.51), and diverticular bleeding (OR 1.51, 95% CI: 1.13–2.02). Ex-smokers also showed a higher risk of diverticulosis compared to non-smokers (OR 1.31, 95% CI: 1.08–1.59). Alcohol consumption was associated with an increased risk of colonic diverticulosis (OR 1.41, 95% CI: 1.09–1.82). However, no association was found between alcohol consumption and diverticular bleeding (OR 1.15, 95% CI: 0.77 to 1.71) or diverticulitis (OR 1.36, 95% CI: 0.98 to 1.88). No publication bias was evident in the analysis.
Discussion: Our findings suggest an association between smoking, alcohol consumption, and increased risk of colonic diverticulosis. Smoking is associated with an increased risk of colonic diverticulosis and diverticular bleeding. The relationship between alcohol consumption and diverticular disease requires further investigation. Future research should explore the mechanisms by which these factors influence the development of colonic diverticulosis to understand and inform public health recommendations.
Figure: Forest plots depicting the association of smoking and alcohol consumption, respectively, with colonic diverticulosis. In Figure A, pooled odds ratios demonstrate an elevated risk linked to current and former smoking, while Figure B indicates an increased risk associated with alcohol consumption.
Disclosures:
Sawai Singh Rathore indicated no relevant financial relationships.
Tirath Daishikbhai Patel indicated no relevant financial relationships.
Meghana Kakarla indicated no relevant financial relationships.
Hairya Ajaykumar Lakhani indicated no relevant financial relationships.
Bijay Mukesh Jeswani indicated no relevant financial relationships.
Ujwala Reddy Borra indicated no relevant financial relationships.
Hafiza Amna Qadeer indicated no relevant financial relationships.
Ayesha Anam Syeda indicated no relevant financial relationships.
Sawai Singh Rathore, MBBS1, Tirath Daishikbhai Patel, MS2, Meghana Kakarla, MD3, Hairya Ajaykumar Lakhani, MBBS4, Bijay Mukesh Jeswani, MBBS5, Ujwala Reddy Borra, MBBS6, Hafiza Amna Qadeer, MBBS7, Ayesha Anam Syeda, MBBS8. P1920 - Smoking and Alcohol Consumption as Risk Factors for Colonic Diverticulosis and its Complications: A Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
