Adverse effects of nonsteroidal anti-inflammatory drugs on the colon.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, and a growing body of evidence suggests that they have adverse effects in the lower gastrointestinal (GI) tract in addition to the well-described toxicity in the upper GI tract. Among NSAID users who develop adverse GI effects, the proportion with lower GI events is as high as 40%. Most of the available evidence is taken from case-control studies and case reports; no large, randomized, placebo-controlled study has specifically set out to determine the magnitude of NSAID toxicity on the colon. However, the data suggest that NSAIDs cause a primary macroscopic colitis, collagenous colitis, an increased risk of complicated diverticular disease, and exacerbations of preexisting inflammatory bowel disease. Treatment depends on withdrawal of the causative drug.
Ballinger
Anne
A
Queen Elizabeth the Queen Mother Hospital, St Peter's Road, Margate CT9, UK. anne.ballinger@ekht.nhs.uk
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003092:Colitis / Q000139:chemically induced; D003106:Colon / Q000187:drug effects*; D003108:Colonic Diseases / Q000139:chemically induced*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans
D000894:Anti-Inflammatory Agents, Non-Steroidal
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