Do statins cause diarrhoea
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Do Statins Cause Diarrhea?
Statins and Gastrointestinal Side Effects
Statins, widely prescribed for lowering cholesterol, have been associated with various gastrointestinal side effects, including diarrhea. However, the evidence on this association is mixed and warrants a closer examination.
Statins and Clostridioides difficile Infection (CDI)
Clostridioides difficile infection (CDI) is a significant cause of nosocomial diarrhea. A study examining veterans with CDI found that statin use was associated with lower 30-day mortality rates compared to non-users, but it did not significantly affect the recurrence of CDI within 60 days 1. This suggests that while statins may have beneficial effects on CDI outcomes, they do not necessarily increase the risk of diarrhea associated with CDI.
Protective Effects Against Clostridium difficile-Associated Diarrhea (CDAD)
Another study investigated whether prior statin use could protect against the development of Clostridium difficile-associated diarrhea (CDAD) in hospitalized patients. The findings indicated that patients who used statins had a lower prevalence of CDAD compared to non-users 2. This suggests a potential protective effect of statins against this specific type of diarrhea.
Statins and General Lower Gastrointestinal Conditions
A comprehensive retrospective cohort study evaluated the association between statin therapy and various lower gastrointestinal conditions, including diarrhea. The study found no statistically significant difference in the occurrence of constipation, abdominal pain, or colitis between statin users and non-users. Interestingly, the study reported decreased odds of diarrhea among statin users 3. This finding contradicts some package inserts that list diarrhea as a common side effect of statins.
Conclusion
The current body of research suggests that statins do not significantly increase the risk of diarrhea. In fact, some studies indicate that statin use may be associated with a lower risk of certain types of diarrhea, such as Clostridium difficile-associated diarrhea. While gastrointestinal side effects are a concern with many medications, the evidence does not strongly support the notion that statins cause diarrhea. Further research is needed to fully understand the relationship between statin use and gastrointestinal health.
Sources and full results
Most relevant research papers on this topic
A possible association between statin use and improved Clostridioides difficile infection mortality in veterans
Statin use is associated with lower 30-day mortality in veterans with Clostridioides difficile infection, but not with 60-day recurrence.
Observational Study
Rigorous JournalDo statins protect against the development of Clostridium difficile-associated diarrhoea?
Prior statin use may provide protection against Clostridium difficile-associated diarrhoea in hospitalized patients.
Observational StudyStatins and Lower Gastrointestinal Conditions: A Retrospective Cohort Study
Statin therapy is not associated with increased likelihood of diagnosing lower gastrointestinal conditions, contrary to some package inserts.
Observational StudyRigorous JournalStatin Use and Risk of Cirrhosis and Related Complications in Patients With Chronic Liver Diseases: A Systematic Review and Meta‐analysis
Statin use is likely associated with lower risk of hepatic decompensation and mortality, and may reduce portal hypertension, in patients with chronic liver diseases.
Meta-Analysis
Highly CitedStatin safety: a systematic review.
Statins are generally safe, with a small risk of peripheral neuropathy and no significant cognitive changes in elderly patients.
Systematic ReviewHighly CitedStatin Use and the Risk of Hepatocellular Carcinoma: A Meta-Analysis of Observational Studies
Statin use is significantly associated with a reduced risk of hepatocellular carcinoma (HCC), particularly in patients with diabetes, liver cirrhosis, and antiviral therapy.
Meta-AnalysisRigorous JournalHighly CitedStatin-Associated Side Effects.
Statins are well-tolerated but may cause rare side effects like statin-associated muscle symptoms, diabetes mellitus, and central nervous system complaints.
Very Rigorous JournalHighly CitedStatins: Adverse reactions, oxidative stress and metabolic interactions
Statins can cause liver, kidney, and muscle toxicities, with oxidative stress playing a key role in these adverse reactions, and antioxidants may offer protection against these toxicities.
Literature ReviewHighly CitedThe safety of statins in clinical practice
Statins are effective cholesterol-lowering drugs with rare adverse effects on muscle and liver, but their widespread use can significantly reduce cardiovascular disease risk.
Rigorous JournalHighly CitedNon-cardiovascular effects associated with statins
Statins have multiple non-cardiovascular effects, including a modest increase in myositis risk and an increase in diabetes risk, but their cardiovascular benefits generally outweigh these risks in patients above a certain threshold.
Systematic ReviewVery Rigorous JournalHighly Cited