title: Rectal stricture associated with the long-term use of ibuprofen suppositories.
abstract: Here, we report the case of a 64-year-old woman who suffered from chronic lower backache for which she received ibuprofen suppositories. The patient was admitted to the hospital with a suspected rectal tumor. Clinical examination did not reveal any abnormal finding apart from a mild, bilateral peritibial edema. On rectal examination, an area of stenosis was detected approximately 7 cm above the anal verge. All laboratory parameters, including different tumor markers, were within normal range. Pelvic CT scan and colonoscopy revealed a circular rectal stenosis with severe destruction of the rectal mucosa. The rectal biopsy taken during endoscopy showed severe acute and chronic ulceration, chronic granulation and fibrosis with lymphocytic infiltration. After exclusion of sexually transmitted diseases such as syphilis and lymphogranuloma venerium or exposure to drugs as a possible cause of rectal stenosis, the history in this particular case suggests that the prolonged use of the cyclooxygenase (COX) inhibitor "ibuprofen" as a suppository is the cause of mucosal destruction and rectal stenosis.
authors.affiliation: Department of Molecular and Experimental Medicine, Division of Arthritis Research, Scripps Research Institute, Mail Drop MEM 161, 10550 N. Torrey Pines Rd., La Jolla, CA 92037, USA. salam@scripps.edu
authors.forename: S
authors.initials: S
authors.lastname: Alsalameh
authors.forename: R
authors.initials: R
authors.lastname: al-Ward
authors.forename: P
authors.initials: P
authors.lastname: Berg
authors.forename: T
authors.initials: T
authors.lastname: Aigner
authors.forename: C
authors.initials: C
authors.lastname: Ell
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000009:adverse effects*; D007415:Intestinal Obstruction / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008875:Middle Aged; D012002:Rectal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D013488:Suppositories; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013488:Suppositories; D007052:Ibuprofen