K. Kurahara et al., Clinical and endoscopic features of nonsteroidal anti-inflammatory drug-induced colonic ulcerations, AM J GASTRO, 96(2), 2001, pp. 473-480
OBJECTIVE: Clinical and endoscopic features of nonsteroidal anti-inflammato
ry drug (NSAID)-induced colonic ulcerations have not been fully investigate
d.
METHODS: During a 3-yr period from April 1996 to March 1999, 6076 subjects
underwent total colonoscopy at our institutions. Among them, the diagnosis
of NSAID-induced colonic ulceration was made by their clinical and colonosc
opic findings. All patients diagnosed as having this disease underwent uppe
r endoscopy and follow-up colonoscopy. Clinical features, serial changes in
colonoscopic findings, and upper GI lesions were analyzed.
RESULTS: Among the subjects, 14 patients were diagnosed as having NSAID-ind
uced ulcerations. Seven patients were complicated by renal failure. Three p
atients had gastric ulcers concurrently. Eleven patients had colonic lesion
s in the ileocecal region. In 13 of 14 patients, initial colonoscopy demons
trated sharply demarcated, semilunar or circumferential ulcers without stri
cture formation. After discontinuance of NSAIDs, improvement of the ulcers
without stricture or inflammatory polyps could be confirmed 3-10 wk later.
In one patient with diaphragm-like stricture, follow-up colonoscopy perform
ed 2 yr later demonstrated resolution of circumferential ulcer.
CONCLUSIONS: NSAID-induced colonic ulceration may occur more frequently tha
n previously recognized. Frank ulcerations, rather than stricture formation
, seem to be the typical colonoscopic signs of NSAID-induced colonic ulcera
tion. (C) 2001 by Am. Cell. of Gastroenterology.