“Abdominal pain” due to angiotensin converting enzyme inhibitor and angiotensin receptor blocker treatment

Abstract

ÖZETAmaç: Anjiotensin konverting enzim inhibitörleri (ACEİ) ve anjiotensin reseptör blokerleri (ARB) hipertansiyon tedavisinde ilk sırada reçete edilen ilaçlar arasındadır. Bu grup ilaçların farkındalık düzeyi düşük bir yan etkisi de; intestinal ödeme bağlı olarak ortaya çıkan karın ağrısı ataklarıdır. Bu advers etki ile ilgili yayınlar olgu sunumu ve literatür taramaları şeklindedir. Gereç ve Yöntem: Necmettin Erbakan ÜniversitesiMeram Tıp Fakültesi etik kurulundan onay alınarak, aynı hastanenin iç hastalıkları polikliniklerine herhangi bir şikayetle müracaat etmiş 8736 hastadan hipertansiyon endikasyonu ile ACEİ ve ARB kullanmakta olduğu tespit edilen 1010 hasta çalışmaya dahil edildi. Hastaların bu ilaçları kullanmaya başladıktan sonra oluşan dil-dudakta şişlik, öksürük ve karın ağrısı semptomları sorgulandı. Karın ağrısı şikayeti olup herhangi bir patoloji saptanamayan hastalar, çalışmanın hedefini oluşturacak grup olarak belirlendi. Abdominal pain due to intestinal edema is another adverse effect which is not well recognized and so with lower levels of awareness. Data about this adverse effect is insufficient and limited with case reports. Materials and Methods:This study was approved by the Local Ethics Committee conducted at Meram Faculty of Medicine, Necmettin Erbakan University. A total of 8736 patients were evaluated who were admitted to outpatient clinic of internal medicine, Meram Faculty of Medicine. A total of 1010 patients were included in the study who were on ACEI or ARB therapy. The new symptoms of angioedema on lips and tongue, cough and abdominal pain were questioned after usage of these drugs. The patients with abdominal pain but without any pathology were selected as the study group.Results: 650 (64.3%) of the patients were female and 360 (35.6%) of them were male. The mean age was 52±8.02. 553 (55.3%) of patients were on ARB and 447 (44.7%) of them were on ACEI therapy. The mean duration of drug usage was 60±7.4 months for ACEI and 56±8 months for ARB. A total of 12 patients (ACEI=7, ARB=5) were found with abdominal pain. Conclusion:Abdominal pain due to intestinal angioedema may be seen during ACEI and/or ARB usage. The gastrointestinal adverse effects of these drugs may be better recognized by physicians as the level of awareness as increased.