Adverse effects of NSAIDs on colopathies in older age


Authors: MUDr. Jan Trna;  Ph.D. 1;  MUDr. Oldřich Stibůrek;  Ph.D. 1;  MUDr. Ivo Novotný, CSc. 2
Authors‘ workplace: Interní gastroenterologická klinika LF MU a FN Brno 1;  Gastroenterologické oddělení Masarykův onkologický ústav 2
Published in: Geriatrie a Gerontologie 2014, 3, č. 4: 199-201
Category: Review Article

Overview

The use of nonsteroidal antiinflammatory drugs (NSAIDs) is often associated with side effects, most frequently gastrointestinal (GI) damage. Lower GI damage (including colon) is increasingly recognized in addition to the generally known upper GI damage. The use of enteric-coated and slow-release forms of NSAIDs is one of the reasons, because larger amount of the compound reaches the distal parts of GI tract. Certain types of colopathies are more prevalent in older age, which is also frequently associated with chronic NSAID abuse. This review describes the negative effect of NSAIDs on colopathies typical for older age. Both NSAID colopathy (caused directly by NSAIDs) and NSAID effect on the increased risk of diverticular bleeding and the course of microscopic colitis are discussed.

Keywords:
NSAID, side effect, colopathy, geriatrics, diverticulum, bleeding, microscopic colitis


Sources

1. Green GA. Understanding NSAIDs: from aspirin to COX-2. Clin Cornerstone 2001; 3:50–60.

2. Buffum M, Buffum JC. Nonsteroidal anti-inflammatory drugs in the elderly. Pain Manag Nurs 2000; 1:40–50.

3. García Rodríguez LA, Jick H. Risk of upper gastrointestinal bleeding and perforation associated with individual non-steroidal anti-inflammatory drugs. Lancet 1994; 343: 769–72.

4. Lanas A, García-Rodríguez LA, Polo-Tomás M, et al. The changing face of hospitalisation due to gastrointestinal bleeding and perforation. Aliment Pharmacol Ther 2011; 33: 585–591.

5. Byrne MF, McGuinness J, Smyth CM, et al. Nonsteroidal antiinflammatory drug-induced diaphragms and ulceration in the colon. Eur J Gastroenterol Hepatol 2002; 14: 1265–1269.

6. Tanner AR, Raghunath AS. Colonic inflammation and non-steroidal anti-inflammatory drug administration. An assessment of the frequency of the problem. Digestion 1988; 41: 116–20.

7. Schiffmann L, Kahrau S, Berger G, Buhr HJ. Colon perforation in an adolescent after short-term diclofenac intake. ANZ J Surg 2005; 75(8): 726–7.

8. Laine L, Connors LG, Reicin A, et al. Serious lower gastrointestinal clinical events with nonselective NSAID or coxib use. Gastroenterology 2003; 124: 288–92.

9. Kurahara K, Matsumoto T, Iida M, et al. Clinical and endoscopic features of nonsteroidal anti-inflammatory drug-induced colonic ulcerations. Am J Gastroenterol 2001; 96: 473–480.

10. Chan FK, Lanas A, Scheiman J, et al. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet 2010; 376: 173–179.

11. Laine L, Curtis SP, Langman M, et al. Lower gastrointestinal events in a double-blind trial of the cyclo-oxygenase-2 selective inhibitor etoricoxib and the traditional nonsteroidal antiinflammatory drug diclofenac. Gastroenterology 2008; 135: 1517–1525.

12. Smith JA, Pineau BC. Endoscopic therapy of NSAID-induced colonic diaphragm disease: two cases and a review of published reports. Gastrointest Endosc 2000; 52: 120–5.

13. Gombošová L, Zakuciová M, Veseliny E. Nesteroidovými antireumatikami indukovaná kolopatia imitujúcaCrohnovu chorobu. Gastroent Hepatol 2010; 64: 15–20

14. Hayllar J, Price AB, Smith T, et al. Nonsteroidal antiinflammatory drug-induced small intestinal inflammation and blood loss: effect of sulphasalazine and other disease modifying drugs. Arthr Rheum 1994; 37: 1146–1150.

15. Gopal DV, Katon RM. Endoscopic balloon dilation of multiple NSAID-induced colonic strictures: case report and review of literature on NSAID-related colopathy. Gastrointest Endosc 1999; 50: 120–3.

16. Pilgrim S, Velchuru V, Waters G, et al. Diaphragm disease and small bowel enteropathy due to nonsteroidal anti-inflammatory drugs: a surgical perspective. Colorectal Dis 2011; 13: 463–6.

17. Jun S, Stollman N. Epidemiology of diverticular disease. Best Pract Res Clin Gastroenterol 2002; 16: 529–42.

18. Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 1997; 92: 419–24.

19. Yamada A, Sugimoto T, Kondo S, et al. Assessment of the risk factors for colonic diverticular hemorrhage. See comment in PubMed Commons belowDis Colon Rectum 2008; 51: 116–20.

20. Aldoori WH, Giovannucci EL, Rimm EB, et al. Use of acetaminophen and nonsteroidal anti-inflammatory drugs: a prospective study and the risk of symptomatic diverticular disease in men. See comment in PubMed Commons belowArch Fam Med 1998; 7: 255–60.

21. Wilson RG, Smith AN, Macintyre IM. Complications of diverticular disease and non-steroidal anti-inflammatory drugs: a prospective study. Br J Surg 1990; 77: 1103–4.

22. Zuckerman GR, Prakash C. Acute lower intestinal bleeding. Part II: etiology, therapy, and outcomes. Gastrointest Endosc 1999; 49: 228–38.

23. McGuire HH Jr, Haynes BW Jr. Massive hemorrhage for diverticulosis of the colon: guidelines for therapy based on bleeding patterns observed in fifty cases. Ann Surg 1972; 175: 847–55.

24. Fernández-Bañares F, Salas A, Forné M, et al. Incidence of collagenous and lymphocytic colitis: a 5-year population-based study. Am J Gastroenterol 1999; 94: 418–23.

25. Riddell RH, Tanaka M, Mazzoleni G. Non-steroidal anti-inflammatory drugs as a possible cause of collagenous colitis: a case-control study. See comment in PubMed Commons belowGut 1992; 33: 683–6.

26. Wilcox GM, Mattia AR. Microscopic colitis associated with omeprazole and esomeprazole exposure. J Clin Gastroenterol 2009; 43: 551–553.

27. Chagnon JP, Cerf M. Simvastatin-induced protein-losing enteropathy. Am J Gastroenterol 1992; 87: 257.

28. Schiller LR. Diagnosis and management of microscopic colitis syndrome. J Clin Gastroenterol 2004; 38(Suppl 1): S27–30.

29. MJ Stewart, CH Seow, M Storr, et al.: Prednisolone and budesonide for short-and long-term treatment of microscopic colitis: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2011; 9: 881–890.

Labels
Geriatrics General practitioner for adults Orthopaedic prosthetics
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account