Celecoxib associated esophagitis: review of gastrointestinal side effects from cox-2 inhibitors.
BACKGROUND
With the extensive use of COX-2 inhibitors to treat inflammatory and pain syndromes, gastrointestinal adverse effects are being increasingly observed.


METHODS
An 87-year-old white man with chronic peptic esophageal stricture presented to us with dysphagia and odynophagia. The patient was taking Celecoxib for 5 months for trigeminal neuralgia. An upper endoscopy revealed severe desquamative esophagitis. Celecoxib was discontinued and the patient was started on esomeprazole. The patient's symptoms improved in 1 month. Three months later, EGD revealed complete healing of the esophageal mucosa.


CONCLUSIONS
Because recent studies have shown that COX-2 inhibitors are similar to NSAIDs with regards to absorption, in contrast to premarketing trials, extensive use of COX-2 inhibitors is likely to demonstrate gastrointestinal adverse effects similar to those caused by traditional NSAIDs. Our patient had severe esophagitis caused by Celecoxib and aggravated by reflux of achlorhydric gastric contents after dilatation of the stricture.


CONCLUSIONS
We report for the first time severe esophagitis caused by the COX-2 inhibitor Celecoxib.
Mantry
Parvez
P
Department of Medicine, Digestive Diseases Unit, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA. parvez_mantry@urmc.rochester.edu
Shah
Ashok
A
Sundaram
Uma
U
D000368:Aged; D000369:Aged, 80 and over; D000068579:Celecoxib; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D004940:Esophageal Stenosis / Q000188:drug therapy; D004941:Esophagitis / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008297:Male; D011720:Pyrazoles; D013449:Sulfonamides / Q000009:adverse effects*; D014277:Trigeminal Neuralgia / Q000188:drug therapy
D016861:Cyclooxygenase Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib