Tolerance of nonsteroidal antiinflammatory drugs in patients with inflammatory bowel disease

Abstract

Among this group of outpatients, NSAID use was not associated with a higher likelihood of active IBD. NSAID use in IBD deserves further study before recommending that patients refrain from their use under all circumstances.

Relapse of Inflammatory Bowel Disease Associated With Use of Nonsteroidal Anti-Inflammatory Drugs

“…Smale et al (14) reported that 25% of IBD patients treated for 1 month with naproxen or nabumetone had clinical relapse. A series of retrospective studies has found no association between the use of NSAIDs and IBD relapse (15,16). Bonner and Vennamaneni (17) completed a prospective cohort study to examine the use of NSAIDs (including over-the-counter medications) and disease activity in 368 patients with IBD.…”

Do Non-steroidal Anti-inflammatory Drugs Cause Exacerbations of Inflammatory Bowel Disease?

“…A retrospective study reported in 2000 comprising outpatients with IBD (both Crohn's disease and ulcerative colitis) compared the frequency of NSAID usage in patients whose disease flared with that of patients whose IBD remained quiescent [30]. The investigators found no significant differences in the frequency of NSAID usage between those two groups.…”

The Role of Arachidonic Acid Regulatory Enzymes in Colorectal Disease

“…They found that only 7.4 percent of patients who used COX-2 inhibitors for a median duration of nine months had aggravation of their IBD. 69 Similarly, Bonner et al 70 found that there was no significant difference in exacerbation of IBD among 368 patients with IBD who were not taking NSAIDS, low-dose NSAIDs, or high-dose NSAIDs.…”

“…68 In contrast, some studies have found no link between NSAID use and exacerbation of IBD. [69][70][71] Karmeli et al 72 found that COX-2 inhibitors have a beneficial effect on experimental colitis in rats, via reducing colonic eicosanoids generation. 72 However, Lesch et al 73 showed that COX-2 inhibitors have no beneficial effect in experimental colitis.…”

“…No effect Bonner et al 70 Retrospective No effect NSAIDs = nonsteroidal anti-inflammatory drugs; IBD = inflammatory bowel disease. ulceration and inflammation in numerous animal studies.…”