BLOODY DIARRHEA AND COLONIC ULCERATION AF TER NSAID INGESTION

The lower digestive tract, in contrast to the gastroduodenal tract, is infrequently affected by non-steroidal antiinflammatory drugs (NSAID) , and rarely referred to in medical literature. We report the case of a 40 year old man who presented with bloody diarrhea following treatme nt with NSAID. The fibrogastroscopy was normal. The fibrocolonoscopy s howed elongated apthous ulcers with librin, in the sigmoid colon. Othe rs studies were normal. After withdrawal of NSAID, the patient returne d to normal, as did the fibrocolonoscopy. The treatment with NSAID has been linked with ulcerative lesions in the lower digestive tract, per foration, bloody lesions, perforation of diverticuli, reactivation of quiescent colitis and stenosis. In spite of this, doubts persist about the frequency of presentation, high risk doses and its pathophysiolog ical mechanism, which probably involves blocking the cyclooxigenase sy stem and the formation of the leukotrienes and free oxygen radicals. T aking into consideration the above factors, more care should be taken in investigating colonic involvement in patients who present with gast rointestinal bleeding following treatment with NSAID.