Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans

doi:10.1016/0016-5085(87)90909-7

Gastroenterology

Volume 93, Issue 3, September 1987, Pages 480-489

https://doi.org/10.1016/0016-5085(87)90909-7 Get rights and content

Abstract

This study examines the effects of nonsteroidal antiinflammatory drugs on the small intestine in humans. Using an ¹¹¹In-leukocyte technique in patients with rheumatoid arthritis (n = 90) and osteoarthritis (n = 7), it appears that (a) nonsteroidal antiinflammatory drugs cause small intestinal inflammation in two-thirds of patients on long-term treatment and (b) on discontinuation, the inflammation may persist for up to 16 mo. The prevalence and magnitude of the intestinal inflammation was unrelated to the type and dose of nonsteroidal drugs and previous or concomitant second-line drug treatment. There was a significant inverse correlation (r = − 0.29, p < 0.05) between fecal ¹¹¹In excretion and hemoglobin levels in patients treated with nonsteroidal antiinflammatory drugs. The kinetics of fecal indium 111 excretion in patients treated with nonsteroidal antiinflammatory drugs was almost identical to that of patients with small bowel Crohn's disease. Eighteen patients on nonsteroidal antiinflammatory drugs underwent a radiologic examination of the small bowel and 3 were found to have asymptomatic ileal disease with ulceration and strictures. Nineteen patients on nonsteroidal antiinflammatory drugs, 20 healthy controls, and 13 patients with Crohn's ileitis underwent a dual radioisotopic ileal function test with tauro 23 (⁷⁵Se) selena-25-homocholic acid and cobalt 58-labeled cyanocobalamine. On day 4, more than half of the patients with rheumatoid arthritis had evidence of bile acid malabsorption, but the ileal dysfunction was much milder than seen in patients with Crohn's ileitis.

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Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans

Abstract

Gastroenterology

Gastroenterology

Lancet

Lancet

Gastroenterology

Gastroenterology

Gastroenterology

Small intestinal ulcers and intestinal flora in rats given indomethacin

Am J Pathol

Indomethacin-induced intestinal inflammation

Am J Dig Dis

Resistance of germ free rats to indomethacin-induced intestinal lesions

Prostaglandins

Xylose test; effect of aspirin and indomethacin

Br Med J

Malabsorption in rheumatoid arthritis

Ann Rheum Dis

Intestinal permeability: clinical correlates

Dig Dis

The effect of non-steroidal anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine

Gut

a seven day variability study of 480 patients with peripheral rheumatoid arthritis

Arthritis Rheum

Total body potassium calibrations for normal and obese subjects in two types of whole body counter

Phys Med Biol

Critical analysis of the accuracy of a combiped radioisotopic test (75Se-HCAT and 58Co-VitB12) of ileal function using a whole-body counter

Clin Phys Physiol Meas

Indium-111 autologous leucocytes in inflammatory bowel disease

Gut

Critical analysis of the accuracy of a combiped radioisotopic test (⁷⁵Se-HCAT and ⁵⁸Co-VitB₁₂) of ileal function using a whole-body counter