INTESTINE Vol.18 No.4(5)

Theme Differential diagnosis for common enterocolitis, especially in endoscopic findings
Title NSAID-induced colopathy
Publish Date 2014/07
Author Kazeo Ninomiya Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Takashi Hisabe Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Shigeyoshi Yasukawa Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Hiroshi Ishihara Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Takashi Nagahama Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Yasuhiro Takaki Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Fumihito Hirai Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Kenshi Yao Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Toshiyuki Matsui Department of Gastroenterology, Fukuoka University Chikushi Hospital
[ Summary ] In addition to its use for analgesia and as an overall antipyretic, an increase in the frequency of nonsteroidal anti-inflammatory drug (NSAID) use for antithrombotic therapy has been seen in recent years. NSAID-induced colopathy is observed in approximately 3 % of those classified endoscopically as being of the ulcerous type or being associated with colitis. The ulcerous type is further classified based on the presence or absence of complications with diaphragm-like strictures. It is commonly found in the right colon with characteristic annular, sharply demarcated ulcers along the haustra. Colitis types can be present when there are aphthous or hemorrhagic findings. While symptoms usually improve after discontinuation of the offending drug, stenotic lesions may remain, potentially requiring endoscopic or surgical therapy. Differentiation from other inflammatory bowel diseases can be challenging, in which case, obtaining detailed clinical and drug histories, in addition to diagnostic imaging, is important for diagnosis.
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