Colonic ulcers accompanying collagenous colitis: implication of nonsteroidal anti-inflammatory drugs.

Abstract

OBJECTIVES:

A small minority of otherwise typical collagenous colitis (CC) patients also have mucosal ulceration (CC-U). We studied the association of CC-U cases with ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs) as a possible explanation for the mucosal ulceration.

METHODS:

Clinical information and histological features were reviewed in nine cases of biopsy-diagnosed CC-U. Biopsies from 18 unselected cases of CC without ulceration were reviewed for comparison.

RESULTS:

Of nine patients with CC-U, seven (77.8%) had a history of NSAID ingestion, compared with four of 18 CC controls (20.2%) (p = 0.006). The diarrhea resolved after cessation of NSAID use in four CC-U patients, partially resolved in one patient, and persisted in one patient. The outcome was not available in one patient. Of the two CC-U patients who did not use NSAIDs, one patient was taking lisinopril (angiotensin-converting enzyme inhibitor), and the diarrhea resolved after stopping the drug; the ulceration in the second patient was thought to be ischemic in origin.

CONCLUSIONS:

Collagenous colitis with ulceration has a strong association with NSAID ingestion. Evaluation of medications and cessation of NSAIDs should be considered as a therapeutic option in cases of collagenous colitis with colonic ulceration.

• Authors: Sanjay Kakar, Darrell S Pardi, Lawrence J Burgart
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 98 Issue 8 Pg. 1834-7 (Aug 2003) ISSN: 0002-9270 [Print] United States
• PMID: 12907340 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Colitis (complications, drug therapy, pathology)
• Colonoscopy
• Female
• Humans
• Intestinal Mucosa (pathology)
• Male
• Middle Aged
• Ulcer (chemically induced, complications, diagnosis)