Drug-induced gastrointestinal disorders

Abstract

Drug-induced gastrointestinal disorders can mimic conditions, such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) and, hence, recognition can prevent unnecessary investigations and treatment. While the knowledge and awareness relating to the adverse gastrointestinal effects of some medications, such as non-steroidal anti-inflammatory drugs are well established, other commonly prescribed drugs, such as antipsychotics, antidepressants and metformin are less well understood and warrant further study. This review attempts to integrate recent information regarding adverse drug reactions and place this in a useful clinical context.

Nightmare and Abnormal Dreams: Rare Side Effects of Metformin?

“…Despite the fact that the efficacy of metformin offers wide range of benefits beyond its glycemic control, physicians have always been well-aware of its adverse effects [1, 2]. Metformin-induced gastrointestinal symptoms and the debatable lactic acidosis are universally recognized by the clinicians [2, 3]; however its side effects in inducing nightmare and abnormal dreams are not well reported. Herein, we report a probable case of metformin-induced nightmare and abnormal dreams.…”

Doxycycline‐induced oesophageal ulcer in a teenager: A case report

“…Clinical features of pill oesophagitis include sudden‐onset retrosternal chest pain with odynophagia and dysphagia. Painless dysphagia, nausea, vomiting and haematemesis have been reported in association with pill oesophagitis . Symptoms develop from a few hours to days after ingesting the tablet …”

“…Endoscopically, a well‐demarked ulcer in the mid‐oesophagus is the most common finding, but sometimes, impacted pill fragments can be seen . Histological examination typically shows non‐specific acute inflammation . Histological examination is useful to rule out other possible causes of ulcers in the mid‐oesophagus, such as infection (e.g.…”

“…cytomegalovirus or herpes simplex virus) or inflammation (e.g. Crohn's disease or Behcet disease) . Management of drug‐induced oesophageal injury is usually supportive, with a period of rest, while nil by mouth, and intravenous or nasogastric fluid support if the lesion is severe, along with PPI treatment and cessation of the offending drug.…”

Androgen Deprivation Therapy (ADT), Metabolic Syndrome and Metastatic Prostate Cancer: In Vivo and In Vitro Assessments of Effects of Metformin

“…In those patients, low dose metformin or dose escalation was not attempted which has been suggested to be an effective solution to this side effect [229]. No medically significant adverse effects requiring admission into hospital was recorded.…”