NSAIDs, gastrointestinal toxicity and inflammatory bowel disease
Gastroenterol Hepatol. 2022 Mar;45(3):215-222.
doi: 10.1016/j.gastrohep.2021.06.003.
Epub 2021 Jun 19.
[Article in
English,
Spanish]
Affiliations
- 1 Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria (ISS) Aragón, Zaragoza, España. Electronic address: gonzahijos@gmail.com.
- 2 Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria (ISS) Aragón, Zaragoza, España.
- 3 Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria (ISS) Aragón, Zaragoza, España; Departamento de Medicina, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España.
Abstract
Non-steroidal antiinflammatory drugs (NSAIDs) are currently one of the most widely used drugs. The use of NSAIDs is associated with gastrointestinal toxicity, affecting both upper gastrointestinal tract (peptic ulcer disease) and lower gastrointestinal tract (NSAID-induced enteropathy). NSAIDs use has been associated with an increased risk of clinical relapse in inflammatory bowel disease patients. In this article, we review the upper and lower gastrointestinal toxicity of NSAIDs, with a focus on the risks and specific data of these drugs in inflammatory bowel disease patients, giving recommendations for its appropriate use in the clinical practice. Although evidence is scarce, short-term use of NSAIDs appears to be safe, and the data available suggest that selective COX-2 inhibitors are the safer option. NSAIDs should be avoided as long-term treatment or with high doses, especially in patients with active inflammation.
Keywords:
Antiinflamatorios no esteroideos; Colitis ulcerosa; Crohn's disease; Enfermedad de Crohn; Enfermedad inflamatoria intestinal; Enteropathy; Enteropatía; Inflammatory bowel disease; Nonsteroidal antiinflammatory drugs; Peptic ulcer; Ulcerative colitis; Úlcera péptica.
Copyright © 2021 Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
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Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
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Cardiovascular Diseases / chemically induced
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Cyclooxygenase 2 Inhibitors / administration & dosage
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Cyclooxygenase 2 Inhibitors / adverse effects
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Gastrointestinal Agents / administration & dosage
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Gastrointestinal Diseases / chemically induced*
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Gastrointestinal Diseases / prevention & control
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Humans
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Inflammatory Bowel Diseases / chemically induced
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Intestinal Mucosa / drug effects
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Misoprostol / administration & dosage
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Peptic Ulcer / chemically induced
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Peptic Ulcer / prevention & control
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Protective Agents / administration & dosage
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Recurrence
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Risk Factors
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Cyclooxygenase 2 Inhibitors
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Gastrointestinal Agents
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Protective Agents
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Misoprostol