Colonic strictures in a patient on long-term non-steroidal anti-inflammatory drugs

Monahan, David W.; Starnes, Eddie C.; Parker, Allan

doi:10.1016/s0016-5107(92)70442-8

Cited by 39 publications

(10 citation statements)

References 14 publications

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“…The histology of many diaphragms showed associated areas of ulceration and granulation, supporting the reactive theory of 'healing by fibrosis' [15,20,25]. There was evidence to show the progression of colonic enteropathic ulceration to diaphragms on serial follow-up [9]. An interesting observation was the frequent circumferential 'rim ulcer' noticed at the edge of the diaphragms.…”

Section: Discussionmentioning

confidence: 68%

Diaphragmatic disease of the colon: systematic review

2013

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Section: Discussionmentioning

confidence: 68%

Diaphragmatic disease of the colon: systematic review

2013

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“…Although aspirin‐induced colitis has not been widely reported, 8, 24, 25 the majority of patients in the present study (nine of 13 patients, 69%) took low‐dose aspirin for ICD. Low‐dose aspirin has been recommended for the prevention or minimization of cardiovascular events, 1–4 and NSAIDs are recommended for protection against colorectal cancer 5, 6 .…”

Section: Discussionmentioning

confidence: 68%

Colonic mucosal lesions associated with long‐term administration of non‐steroidal anti‐inflammatory drugs

Ohkusa

Terai

Abe

et al. 2006

Ali Pharm Thera Symp Ser

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Summary Background Effects of long‐term administration of non‐steroidal anti‐inflammatory drugs (NSAIDs) on the colon have not been well characterized. Aim To investigate colonoscopic findings and prevalence of adverse events following long‐term use of NSAIDs. Methods The study included 425 patients (mean 66.4 years) treated for over one year with NSAIDs, and 2125 age‐ and sex‐matched patients without NSAIDs as controls. Eligible candidates were selected by medical record review for underlying diseases, pre‐endoscopic symptoms, category of NSAIDs used, and duration of use. We used endoscopy to study lesion characteristics. Results The occurrence rate of colonic lesions or bleeding in the NSAIDs user (13/425, 3.1%) was higher than that in controls (28/2125, 1.3%) (p = 0.017). Colitis was found in 10 of the 13 patients. The sigmoid colon, descending colon or both (70.0%) was commonly involved, and showed segmental ischemic colitis features in 8 of the 13 patients (61.5%). Among these, duration of use ranged from 1‐30 years (mean 7.8). Nine of 13 patients (69.2%) took low‐dose aspirin. Conclusion The prevalence of colonic lesions in long‐term NSAIDs users is much lower than that of upper gastrointestinal side effects, but higher than that of colonic lesions in non‐NSAIDs users. The most common features of NSAIDs‐associated colitis were segmental ischeznia.

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“…Publications on eight of the 33 previous cases provide no details on treatment or follow-up (5,12,24). Twelve cases were managed with surgical resection (7,8,11,13,(15)(16)(17)(18)23,26); four with endoscopic dilation (19)(20)(21) and nine were managed conservatively by discontinuing NSAID therapy as the sole therapeutic maneuver (6,9,10,12,14,15,22,25).…”

Section: Discussionmentioning

confidence: 99%

“…A paucity of published literature exists on NSAID-associated colonic diaphragms, with only 33 cases reported in the English literature . Case reports have previously documented symptomatic resolution after the discontinuation of NSAID therapy (10,12,15,22,26), after endoscopic dilation (19,21) or after colonic resection (7,8,11,13,(15)(16)(17)(18)23,26), but data on followup colonoscopy or radiology after medical or conservative management is available in only five cases (9,14,15,20,25). Complete healing of diaphragms has been documented only once (20).…”

Section: Guérison De Multiples Sténoses Coliques Graves Causées Par Lmentioning

confidence: 99%

Resolution of Multiple Severe Nonsteroidal Anti-Inflammatory Drug-Induced Colonic Strictures with Prednisone Therapy: A Case Report and Review of the Literature

Penner

Cn²

2003

Canadian Journal of Gastroenterology

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A 69-year-old woman on nonsteroidal anti-inflammatory drugs (NSAIDs) was admitted to a university hospital with abdominal pain, profound anemia and melena stools. Duodenal ulceration and subsequent healing were documented. Colonoscopy revealed haustral ulceration and NSAID-induced colonic diaphragm disease. Discontinuation of NSAID therapy did not result in endoscopic change, but a 20-week course of prednisone was followed by complete resolution. This is the first case describing prednisone monotherapy for such strictures, and only the second in which endoscopic resolution has been documented. With further supporting experience, prednisone may be considered in addition to NSAID discontinuation for patients with this rare but serious complication.

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Colonic strictures in a patient on long-term non-steroidal anti-inflammatory drugs

Cited by 39 publications

References 14 publications

Diaphragmatic disease of the colon: systematic review

Diaphragmatic disease of the colon: systematic review

Colonic mucosal lesions associated with long‐term administration of non‐steroidal anti‐inflammatory drugs

Resolution of Multiple Severe Nonsteroidal Anti-Inflammatory Drug-Induced Colonic Strictures with Prednisone Therapy: A Case Report and Review of the Literature

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