Pathological effects of drugs on the gastrointestinal tract: a review.
Drug-induced injury of the gastrointestinal (GI) tract is increasingly common but generally under-recognized. Although there is an overwhelming number of drugs that are associated with adverse GI effects, there is a limited number of characteristic injury patterns that should prompt consideration of drug-induced GI pathology. These include the following: erosions, ulcers, and strictures; crystal deposition; parietal cell changes; reactive gastropathy; pseudodysplastic changes; microscopic colitis; infectious or necrotizing enterocolitis; ischemic colitis; focal active colitis; and increased epithelial apoptosis. This article reviews morphological and pathophysiological features of some of the more common and pathologically recognizable drug-related injury patterns and provides a practical guide for the recognition and diagnosis of drug-induced pathology in the upper and lower GI tract.
Parfitt
Jeremy R
JR
Department of Pathology, London Health Sciences Centre and University of Western Ontario, London, Ontario, Canada.
Driman
David K
DK
D019386:Alendronate / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D017209:Apoptosis / Q000187:drug effects; D003092:Colitis / Q000139:chemically induced; D064420:Drug-Related Side Effects and Adverse Reactions; D020345:Enterocolitis, Necrotizing / Q000139:chemically induced; D004941:Esophagitis / Q000139:chemically induced; D005756:Gastritis / Q000139:chemically induced; D041981:Gastrointestinal Tract / Q000187:drug effects* / Q000473:pathology*; D006801:Humans; D007413:Intestinal Mucosa / Q000166:cytology / Q000187:drug effects; D007501:Iron / Q000009:adverse effects; D010295:Parietal Cells, Gastric / Q000187:drug effects; D011137:Polystyrenes / Q000009:adverse effects; D054328:Proton Pump Inhibitors; D013276:Stomach Ulcer / Q000139:chemically induced
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011137:Polystyrenes; D054328:Proton Pump Inhibitors; C003321:polystyrene sulfonic acid; D007501:Iron; D019386:Alendronate