Colopathy associated with the systemic use of nonsteroidal antiinflammatory medications. An underestimated entity.
OBJECTIVE
Adverse effects of NSAIDs (nonsteroidal antiinflammatory drugs) on the upper gastrointestinal tract and small intestine are well described. Evidence is also accumulating that implicate NSAIDs in inducing and exacerbating damage in the distal gastrointestinal tract. In this article we describe eight cases of colonic inflammation associated with nonsteroidal antiinflammatory drug administration; our aim is to stress the importance of an underestimated entity by clinicians.


METHODS
Over a five-year period at two clinics, eight cases of NSAID-colopathy have been diagnosed. Crohn's disease, ulcerative and infections colitis have been excluded from this analysis. In all these subjects a careful drug history has been taken in a prospective manner and colonic inflammation appeared to be directly related to NSAID administration. There was a time interval (mean: 20 months) between initiation of treatment with NSAID and presentation with diarrhea, rectal hemorrhage and tenesmus.


RESULTS
A correct diagnosis of colopathy associated with NSAIDs administration was made on careful drug history, pathological findings, stool cultures and biochemical changes which were insignificant, in contrast to the protracted troublesome symptoms. Resolution of symptoms was observed on discontinuation of NSAID medication.


CONCLUSIONS
Our report is further evidence that NSAIDs administration is associated with significant mucosal injury in the distal gastrointestinal tract, despite is underestimated by most physicians.
Katsinelos
Panagiotis
P
Department of Gastroenterology, Theagenion Hospital, Aristotelion University, Ippokration Hospital, Thessaloniki, Greece.
Christodoulou
Kiriakos
K
Pilpilidis
Ioannis
I
Xiarchos
Panagiotis
P
Papagiannis
Adreas
A
Dimiropoulos
Stavros
S
Amperiadis
Periclis
P
Vasiliadis
Themistoklis
T
Tarpagos
Anestis
A
Katsos
Ioannis
I
Eugenidis
Nikos
N
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003092:Colitis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D003113:Colonoscopy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies
D000894:Anti-Inflammatory Agents, Non-Steroidal