Rectal stricture associated with the long-term use of ibuprofen suppositories

Here, we report the case of a 64-year-old woman who suffered from chronic l ower backache for which she received ibuprofen suppositories. The patient w as admitted to the hospital with a suspected rectal tumor. Clinical examina tion did not reveal any abnormal finding apart from a mild, bilateral perit ibial edema. On rectal examination, an area of stenosis was detected approx imately 7 cm above the anal verge. All laboratory parameters, including dif ferent tumor markers, were within normal range. Pelvic CT scan and colonosc opy revealed a circular rectal stenosis with severe destruction of the rect al mucosa. The rectal biopsy taken during endoscopy showed severe acute and chronic ulceration, chronic granulation and fibrosis with lymphocytic infi ltration. After exclusion of sexually transmitted diseases such as syphilis and lymphogranuloma venerium or exposure to drugs as a possible cause of r ectal stenosis, the history in this particular case suggests that the prolo nged use of the cyclooxygenase (COX) inhibitor "ibuprofen" as a suppository is the cause of mucosal destruction and rectal stenosis.