Use of anti-inflammatory drugs by patients admitted with small or large bowel perforations and haemorrhage.

Langman, M. J. S.; Morgan, Larissa E.; Worrall, A.

doi:10.1136/bmj.290.6465.347

Cited by 320 publications

(103 citation statements)

References 5 publications

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“…In another retrospective study, it is noted that those patients who were taking NSAIDs were twice as likely to have small and large bowel perforations or hemorrhage in comparison with control patients [10], further supporting our presumption in this case. …”

Section: Discussionsupporting

confidence: 75%

Nonsteroidal anti-inflammatory drugs: An unusual cause of multiple ileal perforations

Sheredi¹,

Siddiqui²

2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. In this case report, we describe a rare case of pneumoperitoneum with peritonitis due to multiple ileal perforations with a history of high doses of diclofenac sodium usage. Case Report: A young adult male with recent history of high doses of Nonsteroidal antiinflammatory drugs (NSAIDs) presented in emergency department with acute onset pain in right iliac fossa with high grade fever and tachycardia for 12 hours. Abdomen was tender in the right iliac fossa with guarding. X-ray of chest showed free gas under the diaphragm. Exploratory laparotomy was done and showed multiple ileal perforations. Ressection and anastomosis of the affected segment was done, both ends brought as double barrel ileostomy which was reversed later on without any complication. Conclusion: High doses of Nonsteriodal anti-inflammatory drugs can cause multiple ileal erosions and perforation and should be considered in the the differential diagnosis, if other possibilities are excluded.

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Section: Discussionsupporting

confidence: 75%

Nonsteroidal anti-inflammatory drugs: An unusual cause of multiple ileal perforations

Sheredi¹,

Siddiqui²

2015

IJCRI

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“…A connection between corticosteroid treatment and severe septic complications of diverticular disease has been reported.3 In addition, an increased risk of perforation of the small and large bowel, not necessarily related to diverticular disease, has been found in patients who were taking a variety of anti-inammatory drugs. 4 We present here evidence that supports an association between severe septic complications of diverticular disease and both corticosteroid and non-steroidal anti-inflammatory drug treatment.…”

Section: Commentmentioning

confidence: 73%

Steroids, non-steroidal anti-inflammatory drugs, and serious septic complications of diverticular disease.

Corder¹

1987

BMJ

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“…It is well known that NSAIDs induce gastroduodenal ulcers in humans (13,21,23,24,32). Moreover, it was reported recently that NSAIDs induce ulceration in the small intestine and some patients who received NSAIDs chronically died of perforation of the small intestine (1,6,22,28,30). Bjarnason et al (3,4) reported that 70% of the patients receiving long-term NSAID therapy have an asymptomatic enteropathy and occasionally may suffer from intestinal ulcers and strictures.…”

Section: Discussionmentioning

confidence: 99%

Role of Intestinal Bacteria in Ileal Ulcer Formation in Rats Treated with a Nonsteroidal Antiinflammatory Drug

Uejima

Kinouchi

Kataoka

et al. 1996

Microbiology and Immunology

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The role of intestinal bacteria in induction and repression of ulcer formation in the ileum of rats treated with one of the nonsteroidal antiinflammatory drugs (NSAIDs), 5-bromo-2-(4-fluorophenyl)-3-(4-methylsulfonylphenyl) thiophene (BFMeT), was examined in this study. BFMeT was administered by intragastric gavage once at doses of 500-1,500 mg/kg of body weight to Wistar rats treated with and without antibiotics (bacitracin, neomycin, streptomycin), germ-free rats and gnotobiotic rats, and 72 hr later their gastrointestinal tracts were examined for ulcer formation. A single oral administration of BFMeT induced ileal ulcers in specific pathogen-free rats. However, the rats given antibiotics to reduce the intestinal bacteria had no ulcers. BFMeT-treated germ-free rats and gnotobiotic rats mono-associated with Bifidobacterium adolescentis or Lactobacillus acidophilus also had no intestinal ulcers. However, the drug induced ileal ulcers in gnotobiotic rats mono-associated with Eubacterium limosum or Escherichia coli. An overnight culture of B. adolescentis or L. acidophilus or yogurt containing Bifidobacterium breve and Streptococcus thermophilus, when given as drinking water, inhibited ulcer formation in the ileum of rats treated with BFMeT. Gram staining of the ileal contents of normal rats revealed that 97.4% of the stained microorganisms were Gram-positive rods and only 1.2 % were Gram-negative rods. In the group of rats with ulcers induced by BFMeT, the Gram-positive rods decreased by 56.4% and the Gram-negative rods including Escherichia coli, Klebsiella, Proteus and Bacteroides increased by 37.3%. However, in the group of rats administered the Bifidobacterium culture, the Lactobacillus culture or yogurt, the percentages of the Gram-negative rods were decreased. Although Lactobacillus was a major bacterium in the ileum of normal rats, the Gram-negative facultatively anaerobic rods E. coli, Klebsiella and Proteus were increased in the ulcerated ileum of rats treated with BFMeT, suggesting that these bacteria are associated with ulcer formation in rats treated with NSAIDs, and that Lactobacillus and Bifidobacterium inhibit it by repressing the growth of ulcer-inducing bacteria.

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Use of anti-inflammatory drugs by patients admitted with small or large bowel perforations and haemorrhage.

Cited by 320 publications

References 5 publications

Nonsteroidal anti-inflammatory drugs: An unusual cause of multiple ileal perforations

Nonsteroidal anti-inflammatory drugs: An unusual cause of multiple ileal perforations

Steroids, non-steroidal anti-inflammatory drugs, and serious septic complications of diverticular disease.

Role of Intestinal Bacteria in Ileal Ulcer Formation in Rats Treated with a Nonsteroidal Antiinflammatory Drug

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