Nonsteroidal anti-inflammatory drug-induced enteropathy: case discussion and review of the literature

Mayo Clin Proc. 1995 Jan;70(1):55-61. doi: 10.1016/S0025-6196(11)64666-1.

Abstract

The adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal tract are well described. Evidence also shows that NSAIDs can be harmful to the small intestine. The use of NSAIDs has been associated with small intestinal strictures, ulcerations, perforations, diarrhea, and villous atrophy. Herein we present a case of NSAID-induced enteropathy with multiple diaphragm-like strictures that involved the distal 35 cm of ileum and review the literature of other cases of NSAID-induced enteropathy in which biopsy specimens were obtained for histologic analysis to rule out other causes. The prevalence of NSAID-induced enteropathy is unknown. Diagnosis can be made by endoscopy or at abdominal exploration. The role of radionuclide scans for diagnosis remains unclear. The pathogenesis is likely multifactorial. Mucosal diaphragms may be specific for NSAID-related disease. Treatment options for NSAID-induced enteropathy are discussed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Female
  • Humans
  • Ileal Diseases / chemically induced
  • Ileal Diseases / diagnosis
  • Ileal Diseases / therapy
  • Intestinal Diseases / chemically induced*
  • Intestinal Diseases / diagnosis
  • Intestinal Diseases / therapy
  • Intestine, Small / drug effects
  • Jejunal Diseases / chemically induced
  • Jejunal Diseases / diagnosis
  • Jejunal Diseases / therapy
  • Male
  • Middle Aged
  • Rats

Substances

  • Anti-Inflammatory Agents, Non-Steroidal