Amphetamine-Related Ischemic Colitis Causing Gastrointestinal Bleeding

Panikkath, Ragesh; Panikkath, Deepa

doi:10.1080/08998280.2016.11929455

Cited by 7 publications

(4 citation statements)

References 9 publications

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Section: Discussionmentioning

confidence: 99%

“…Amphetamine-induced systemic effects have been linked to increased norepinephrine in the peripheral nervous system and could lead to splanchnic vasoconstriction and smooth muscle hyperactivity, followed by potential watershed ischemia leading to ischemic colitis. [6][7][8][9] To further support the association between phentermine and ischemic colitis, a case published in 2016 presented a 36-yearold woman with acute, severe abdominal pain accompanied by rectal bleeding. A computed tomography demonstrated marked mural thickening of the distal transverse, descending, and sigmoid colon consistent with infectious or inflammatory colitis without signs of obstruction or free air.…”

Section: Discussionmentioning

confidence: 99%

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Rare Case of Endoscopically Diagnosed Ischemic Colitis Secondary to Chronic Phentermine Use

Nagi,

Barnes,

Weiss

2024

ACG Case Rep J

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Phentermine is an amine anorectic that acts as a sympathomimetic agent and undergoes hepatic metabolism predominantly through CYP3A4. It is commonly used as a mediation to facilitate weight loss. Side effects of phentermine can include pulmonary hypertension, valvular heart disease, palpitations, increased heart rate or blood pressure, diarrhea, and cognitive impairment. Very rarely, phentermine usage has been associated with causing ischemic colitis. The mechanism of action for ischemic colitis from phentermine is not well defined but will be discussed in this review. We present a case of a woman who used phentermine daily for weight loss and was endoscopically confirmed to have ischemic colitis after presenting with abdominal pain and bloody diarrhea.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rare Case of Endoscopically Diagnosed Ischemic Colitis Secondary to Chronic Phentermine Use

Nagi,

Barnes,

Weiss

2024

ACG Case Rep J

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“…The plasma half-life of amphetamine ranges from 5 to 30 hours, depending on urine flow and pH [14 , 15] . Other authors reported delayed bowel necrosis and ischemic colitis associated with amphetamine and methamphetamine abuse [16] , [17] , [18] .…”

Section: Discussionmentioning

confidence: 99%

Amphetamine-induced small bowel ischemia – A case report

Ciupilan¹,

Gapp²,

Stelzl³

et al. 2020

Radiology Case Reports

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Nonocclusive mesenteric ischemia is most common in elderly patients with multiple comorbidities. Nevertheless, there are some reports of acute bowel ischemia in young patients with a history of recreational drug abuse. We describe the case of a 33-year-old patient who presented with acute abdominal pain following amphetamine consumption. Multidetector computed tomography showed nonocclusive segmental ischemia of the distal ileum, and the patient underwent emergency surgery with ileocecal resection. The patient recovered quickly and was discharged without any postoperative complications. An early and precise diagnosis of patients with intestinal ischemia having a history of amphetamine abuse is of utmost importance for prompt and proper treatment. Especially in younger patients, multidetector computed tomography should be tailored to use with less radiation. A single portal venous scan proved sufficient in our case.

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“…Amphetamines are another illicit drug class that has been associated with colon ischaemia, although less so than cocaine . Similar to cocaine, its main mechanisms of ischaemic injury involve splanchnic vasoconstriction secondary to its sympathomimetic actions . As was the case with cocaine, amphetamine‐induced colon ischaemia seems to be somewhat heterogeneous in its severity and distribution but the classic symptoms, signs, and colonoscopic findings of colon ischaemia are consistent regardless of the cause.…”

Section: Pharmacologic Agents Strongly Associated With Colon Ischaemiamentioning

confidence: 99%

Review article: the pharmacological causes of colon ischaemia

Vodusek

Feuerstadt

Brandt

2018

Aliment Pharmacol Ther

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Summary Background Colon ischaemia is the most common ischaemic disorder of the gastrointestinal system, can affect any segment of the colon, and may present with a range of symptoms. Diagnosis can be challenging due to symptom overlap with other conditions, varied aetiology, and often rapid and self‐resolving course. Aim To review comprehensively the literature regarding the pharmacological aetiologies of colonic ischaemia to enhance the understanding of the various mechanisms of disease, presentations, distribution, and outcomes. Methods A PubMed search for “colon ischaemia” and “ischaemic colitis” alone as well as in combination with various known pharmacologic causes was performed. Only the highest quality and relevant literature was included in this review. The quality of the literature for each association was rated by the authors and a consensus was made when discrepancies were encountered. Only associations that were deemed “moderate” or “strong” were included. Results The literature considering pharmacologically associated colonic ischaemia is diverse, lacks codification and is characterised by numerous case reports and case series. Constipation‐inducing drugs, digoxin, hormonal therapies, illicit drugs, immunomodulators, laxatives, and NSAIDs were strongly associated with colonic ischaemia. Antimicrobials, appetite suppressants, chemotherapies, decongestants, diuretics, ergot alkaloids, serotonin agents, statins, and vasopressor agents were moderately associated. Conclusions Patients presenting with abdominal pain, diarrhoea, or bloody stool need to be evaluated for the possibility of this condition and treated accordingly. Timely diagnosis is necessary to improve patient outcomes. This review aims to increase awareness among clinicians regarding the presentation of pharmacologically induced colonic ischaemia.

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Amphetamine-Related Ischemic Colitis Causing Gastrointestinal Bleeding

Cited by 7 publications

References 9 publications

Rare Case of Endoscopically Diagnosed Ischemic Colitis Secondary to Chronic Phentermine Use

Rare Case of Endoscopically Diagnosed Ischemic Colitis Secondary to Chronic Phentermine Use

Amphetamine-induced small bowel ischemia – A case report

Review article: the pharmacological causes of colon ischaemia

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