Colonic mucosal lesions associated with long-term or short-term administration of nonsteroidal anti-inflammatory drugs.
OBJECTIVE
The effects of short- or long-term administration of nonsteroidal anti-inflammatory drugs (NSAIDs) on the colon have not been well characterized. We assessed the risk of developing colonic mucosal lesions according to the duration of exposure to NSAIDs: short-term and/or long-term use.


METHODS
A case-controlled study was performed by reviewing medical records for endoscopic findings, underlying disease, pre-endoscopic symptoms, category of NSAIDs used and duration of use. The patients underwent colonoscopy between January and October 2004, and 75 colitis cases and 1801 non-colitis controls were identified. The prevalence of NSAID use was compared between the cases and controls. The age- and sex- adjusted odds ratios (OR) were estimated using multiple logistic regression models.


RESULTS
NSAIDs had been used in colitis cases and non-colitis controls for over six months in 20.0% and 12.7%, and for one week in 4.0% and 2.1%. Overall 76.0% and 85.2% had not received NSAIDs. The adjusted OR (95% confidence interval) for colonic mucosal lesions with short- and long term NSAID administration combined vs. non-use was 2.04 (1.16-3.61). When determined separately for short- and long-term NSAID users, the adjusted ORs were 1.48 (0.42-5.25) and 2.21 (1.19-4.11), compared to non-users. These values signify a trend toward an increased frequency of colonic mucosal lesions with longer use of NSAIDs (P=0.011 for trend).


CONCLUSIONS
Long-term use of NSAIDs increased the risk of colonic mucosal lesions, suggesting that NSAIDs may contribute to the pathogenesis of colonic ulcer or colitis.
Shibuya
Tomoyoshi
T
Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan. tomoyosi@juntendo.ac.jp
Ohkusa
Toshifumi
T
Yokoyama
Tetsuji
T
Harada
Akira
A
Beppu
Kazuko
K
Sakamoto
Naoto
N
Osada
Taro
T
Nagahara
Akihito
A
Terai
Takeshi
T
Otaka
Michiro
M
Ogihara
Tatsuo
T
Watanabe
Sumio
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003092:Colitis / Q000139:chemically induced; D003108:Colonic Diseases / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013997:Time Factors; D014456:Ulcer / Q000139:chemically induced*; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal