Effects of Non-Steroid Anti-Inflammatory Drugs on the Lower Gastrointestinal Tract.

Abstract

BACKGROUND & AIMS: Adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDS) on the upper gastrointestinal (GI) tract and small intestine are well described. Evidence is also accumulating that NSAIDS can induce and/or exacerbate the underlying pathology in the distal GI tract. The aim of this study was to estimate the effect NSAIDs on distal GIT
 METHODS: In 79 consecutive patients with chronic user of NSAIDs and 50 matched controls were included in this study which is done in Aldewanyia city. A detailed clinical history and physical examination were taking. Sigmoidoscopy; with or without colonoscopy were done were done to all patients and volunteer candidates, with histopathological study of rectal and colonic biopsies
 RESULTS: Of the 79 cases of patients, 38 (48%) were had lower clinical manifestation and 31(39%) of patients had histopathological which is mainly non-specific colitis vs. 9 (22%), 4(8%) of controls; P < 0.0001). NSAID use was aspirin (alone or combined) in 34.2% of cases, and 70.25% were using other NSAIDs alone or combined. Other independent risk factors were also assessed like smoking, diabetes, and body weight.
 CONCLUSIONS: NSAID use is strongly associated with an increased risk of upper GIT. This review study point up that NSAIDs can cause significant morbidity in some patients ranging from changing of bowel motion, profuse diarrhea, exacerbating of underlying inflammatory bowel disease, to chronic blood loss with iron deficiency anemia. The pathogenesis is likely multifactorial and is thought to be related to inhibition of prostaglandin synthesis with direct effect of drugs or its metabolites.
 The high prevalence of aspirin and other NSAIDs use suggests that adverse effects on GIT are increasing and should increasing the clinical awareness of these adverse effect throughout the GI tract may reduce morbidity. Concomitant NSAID use, smoking, and alcohol use is a widely association.