Lubiprostone induced ischemic colitis.
Ischemic colitis accounts for 6%-18% of the causes of acute lower gastrointestinal bleeding. It is often multifactorial and more commonly encountered in the elderly. Several medications have been implicated in the development of colonic ischemia. We report a case of a 54-year old woman who presented with a two-hour history of nausea, vomiting, abdominal pain, and bloody stool. The patient had recently used lubiprostone with close temporal relationship between the increase in the dose and her symptoms of rectal bleeding. The radiologic, colonoscopic and histopathologic findings were all consistent with ischemic colitis. Her condition improved without any serious complications after the cessation of lubiprostone. This is the first reported case of ischemic colitis with a clear relationship with lubiprostone (Naranjo score of 10). Clinical vigilance for ischemic colitis is recommended for patients receiving lubiprostone who are presenting with abdominal pain and rectal bleeding.
Department of Internal Medicine, Division of Gastroenterology, Saint Francis Hospital, Evanston, IL 60202, United States.
Muhammed
M
Sherid
Humberto
H
Sifuentes
Salih
S
Samo
Parakkal
P
Deepak
Subbaramiah
S
Sridhar
D000527:Alprostadil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D065101:Chloride Channel Agonists; D017091:Colitis, Ischemic / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D003248:Constipation / Q000188:drug therapy; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D000068238:Lubiprostone; D008875:Middle Aged; D028761:Withholding Treatment
D065101:Chloride Channel Agonists; D000068238:Lubiprostone; D000527:Alprostadil
Colonoscopy; Gastrointestinal bleeding; Ischemic colitis; Lubiprostone; Rectal bleeding