Lesions in the Ileum, Jejunum, and Large Intestine Associated with NSAID Therapy

 

Complications in the small and large bowel may include:

(1) bowel obstruction caused by diaphragm-like strictures associated with proliferation of the muscularis mucosae and/or submucosal fibrosis

(2) inflammation (jejunits, ileitis, colitis)

(3) bleeding

(4) ulceration

(5) perforation

(6) diarrhea

 

Difficulties in diagnosis:

(1) NSAID use may be unrecognized, unreported or underappreciated by the patient.

(2) The highest use of NSAIDS is in patients with other reasons for intestinal ischemia, bleeding or ulceration.

 

Unreported NSAID use should be considered in a patient whenever one of the above complications occurs and no other cause can be found. A careful drug history may be able to identify previously unreported use.