Lower gastrointestinal bleeding due to non-steroid anti-inflammatory drug-induced colopathy case report and literature review

ABSTRACT

The adverse effects of non-steroidal anti-inflammatory drugs [NSAIDs] on the upper gastrointestinal [GI] tract and small intestine are well established. The effect of such therapy on the large intestine, so called NSAID-induced colopathy, is less well described. NSAID-induced colopathy usually involves the right colon due to a higher concentration of the drug at this site, but the rectum may also be involved. NSAIDs possibly damage the normal large intestine, which presents as ulceration, colitis and stricture. Even though several studies found that NSAIDs can cause diverticular bleeding and perforation, flare-up of inflammatory bowel disease, and play a role as an etiologic factor in lymphocytic colitis. Inflammatory bowel diseases, malignancy and infectious colitis must be ruled out before establishing the diagnosis of NSAID -induced colopathy. Discontinuation of the offending drug is mandatory. Here, we have reported the case of a 43-year-old female, NSAID user due to low back pain, who was admitted to the hospital with painless hematochezia