BACKGROUND/AIMS: Colonic diverticular hemorrhage (DH) was a rare disease until the 1990s, and its incidence has increased rapidly since 2000 in Japan. In recent years, colonic DH has been the most frequent cause of lower gastrointestinal bleeding (LGIB). Nearly all cases of DH are mild, with the bleeding often stopping spontaneously. Some cases, however, require surgery or arterial embolization. In this study, using a cohort at Fukuoka University Chikushi Hospital, we investigated factors associated with severe colonic DH. METHODS: Among patients with LGIB who underwent colonoscopy at our hospital between 1995 and 2013, DH was identified in 273 patients. Among them, 62 patients (22.7%) were defined as having severe colonic DH according to recurrence of bleeding in a short period, and/or the necessity of transfusion, arterial embolization, or surgery. We then evaluated risk factors for severe DH among DH patients in this retrospective cohort. RESULTS: Among the 273 patients with DH, use of non-steroidal anti-inflammatory drugs (NSAIDs) (odds ratio [OR], 2.801; 95% confidence interval [CI], 1.164–6.742), Charlson Risk Index (CRI) ≥2 (OR, 3.336; 95% CI, 1.154–7.353), right-sided colonic DH (OR, 3.873; 95% CI, 1.554–9.653), and symptoms of cerebral hypoperfusion (such as light-headedness, dizziness, or syncope) (OR, 2.926; 95% CI, 1.310–6.535) showed an increased risk of severe DH even after controlling for other factors. CONCLUSIONS: Severe DH occurred in 23% of DH patients, and NSAID use, CRI ≥2, right-sided colonic DH, and symptoms of cerebral hypoperfusion are suggested to be predictors of severe DH.
Anti-Inflammatory Agents, Non-Steroidal ; Cohort Studies ; Colon* ; Colonoscopy ; Dizziness ; Hemorrhage* ; Humans ; Incidence ; Japan ; Rare Diseases ; Recurrence ; Retrospective Studies ; Risk Factors*

Objective: Studies have reported that animal-assisted therapy (AAT) intervention can improve patient motivation to complete rehabilitation treatment.Methods: AAT was administered four times for a patient whose rehabilitation treatment was hindered by pain and depression following cervical myelopathy surgery. Ward nurses evaluated the patient's behavior and facial expressions before and during each AAT session using our hospital's own Faces Pain Scale. The AAT intervention was timed to coincide with the implementation of training items that were likely to induce pain.Results: The patient, who underwent cervical myelopathy surgery and whose rehabilitation treatment was severely hindered, reported significantly improved treatment motivation after the AAT intervention. A significantly better treatment response was obtained immediately after the AAT intervention. The Faces Pain Scale score was the worst prior to starting AAT (at 5). However, it peaked at 1 and remained there from the initial intervention to the fourth and final intervention. These results suggest immediate and lasting effects of AAT.Conclusion: Significant changes were observed after the initial AAT intervention, suggesting that its effect was more significant for the awareness of pain and motivation for rehabilitation than for pain relief.

Objective: Studies have reported that animal-assisted therapy (AAT) intervention can improve patient motivation to complete rehabilitation treatment.Methods: AAT was administered four times for a patient whose rehabilitation treatment was hindered by pain and depression following cervical myelopathy surgery. Ward nurses evaluated the patient's behavior and facial expressions before and during each AAT session using our hospital's own Faces Pain Scale. The AAT intervention was timed to coincide with the implementation of training items that were likely to induce pain.Results: The patient, who underwent cervical myelopathy surgery and whose rehabilitation treatment was severely hindered, reported significantly improved treatment motivation after the AAT intervention. A significantly better treatment response was obtained immediately after the AAT intervention. The Faces Pain Scale score was the worst prior to starting AAT (at 5). However, it peaked at 1 and remained there from the initial intervention to the fourth and final intervention. These results suggest immediate and lasting effects of AAT.Conclusion: Significant changes were observed after the initial AAT intervention, suggesting that its effect was more significant for the awareness of pain and motivation for rehabilitation than for pain relief.