title: Nonsteroidal anti-inflammatory drug-induced diaphragms and ulceration in the colon.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Beaumont Hospital/Royal College of Surgeons in Ireland, Dublin, Ireland. byrne006@mc.duke.edu
authors.forename: Michael F
authors.initials: MF
authors.lastname: Byrne
authors.forename: Jonathan
authors.initials: J
authors.lastname: McGuinness
authors.forename: Claire M
authors.initials: CM
authors.lastname: Smyth
authors.forename: Diarmuid S
authors.initials: DS
authors.lastname: Manning
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Sheehan
authors.forename: Shravan G
authors.initials: SG
authors.lastname: Bohra
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Patchett
authors.forename: Frank E
authors.initials: FE
authors.lastname: Murray
mesh_terms: 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*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal