title: Drug-induced inflammatory bowel disease and IBD-like conditions.
abstract: The pathogenesis of inflammatory bowel disease (IBD) is multifactorial and results from an interaction between genetic, immunologic, microbial, and environmental factors. Certain drugs could act as a trigger for the disease and have been implicated in the development of new onset IBD in a number a studies. These relationships are based on case reports and cohort studies, as proving this in the context of randomized controlled trials would be difficult. Drugs that have been linked to causing or worsening IBD include isotretinoin, antibiotics, nonsteroidal antiinflammatory drugs, oral contraceptives, mycophenolate mofetil, etanercept, ipilimumab, and rituximab. Bowel preparation for colonoscopy has also been associated with aphthoid lesions that may be confused with IBD. However, given the source of these reports we have to be cautious in the interpretation of the data before concluding that these drugs trigger IBD and what is being observed is not related to other confounding factors. Different pathogenic mechanisms have been suggested for the different drugs listed above. In order to clarify the confusion a comprehensive literature review was performed with the goal of advancing the knowledge on this subject.
authors.affiliation: Inflammatory Bowel Disease Clinic and the Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Dubeau
authors.forename: Marietta
authors.initials: M
authors.lastname: Iacucci
authors.forename: Paul L
authors.initials: PL
authors.lastname: Beck
authors.forename: Gordon W
authors.initials: GW
authors.lastname: Moran
authors.forename: Gilaad G
authors.initials: GG
authors.lastname: Kaplan
authors.forename: Subrata
authors.initials: S
authors.lastname: Ghosh
authors.forename: Remo
authors.initials: R
authors.lastname: Panaccione
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002400:Cathartics / Q000009:adverse effects; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D003879:Dermatologic Agents / Q000009:adverse effects; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015212:Inflammatory Bowel Diseases / Q000139:chemically induced* / Q000175:diagnosis; D015474:Isotretinoin / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002400:Cathartics; D003278:Contraceptives, Oral, Hormonal; D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D015474:Isotretinoin