G A A b st ra ct s opiate analgesics, non-steroidal anti-inflammatory drugs(NSAIDS), corticosteroids, aspirin and calcium antagonists. Results: A total of 899 patients with an incident diagnosis of perforated diverticular disease were identified. Compared with the population that did not smoke the OR of ever smoking was 1.49 (95% confidence interval [95% CI] 1.27-1.76), compared to those with a body mass index (BMI) 30 was 1.31 (95% CI, 1.03-1.66), and compared to those with no comorbidity those with a Charlson index >2 had an OR 2.39 (95% CI, 2.01-2.84) all data were mutually for each other. Current opiate analgesics and steroid use was associated with an increase in perforation (Table1) although the total percentage of cases exposed was small. Current use of a calcium antagonists, NSAIDs and aspirin were not associated with an increased risk of perforation. Data were adjusted for smoking, comorbidity, abdominal pain and BMI. Conclusion: Perforated diverticular disease is a serious surgical emergency and opiate analgesics and oral steroids increase the risk of diverticular perforation however obesity and smoking represent the principal modifiable risk factors at a population level. Table 1. Odds ratio for current use of NSAIDS, Opiate analgesics and steroids adjusted for BMI, smoking and comorbidity.