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NSAID enterocolopathy
Pathology:
1) may cause ulcerations, strictures & perforations of the small bowel & colon when enteric-coated & slow-release preparations are used
2) colonic lesions are most frequently in the cecum & ascending colon
Epidemiology:
- most patients are > 50 years of age
Clinical manifestations:
- diarrhea [2]
- chronic blood loss & iron-deficiency anemia [2]
- worsening of inflammatory bowel disease [2]
Laboratory:
- colonoscopy is recommended for evaluation of colonic bleeding in patients taking NSAIDs
Radiology:
- strictures may be difficult to detect using barium contrast studies
Management:
1) discontinuation of NSAIDs generally results in healing of lesions in 6-8 weeks
2) re-evaluation in 4-6 weeks
Related
non-steroidal anti-inflammatory agent (NSAID)
NSAID gastropathy
General
intestinal disease
adverse drug reaction (ADR)
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Davies NM.
Toxicity of nonsteroidal anti-inflammatory drugs in the large intestine.
Dis Colon Rectum. 1995 Dec;38(12):1311-21.
PMID: 7497845 Review