Nonsteroidal anti-inflammatory drug-induced diaphragms and ulceration in the colon.
The toxic effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the small bowel have been reported extensively. A growing number of reports of toxic effects of NSAIDs on the colon have appeared recently. The clinical presentation, endoscopic appearances and histological findings of so-called NSAID colopathy are quite varied, as illustrated by a series of four patients described in this report. Presenting symptoms and signs in this series include iron-deficiency anaemia and crampy abdominal pain, but alteration of bowel habit, weight loss, and even nausea and vomiting have also been described. One patient in this series has large-bowel diaphragms, considered by some to be pathognomonic of NSAID effects. Each of the four patients had right-sided colonic lesions only, possibly supporting a direct toxic effect of NSAIDs. Management usually involves simply stopping the offending NSAID. A review of the literature on this under-recognized entity is presented.
Byrne
Michael F
MF
Department of Gastroenterology, Beaumont Hospital/Royal College of Surgeons in Ireland, Dublin, Ireland. byrne006@mc.duke.edu
McGuinness
Jonathan
J
Smyth
Claire M
CM
Manning
Diarmuid S
DS
Sheehan
Katherine M
KM
Bohra
Shravan G
SG
Patchett
Stephen E
SE
Murray
Frank E
FE
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003108:Colonic Diseases / Q000139:chemically induced*; D003251:Constriction, Pathologic / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014456:Ulcer / Q000139:chemically induced*
D000894:Anti-Inflammatory Agents, Non-Steroidal