NSAID-INDUCED COLOPATHY: INCIDENCE, CLINICAL AND ENDOSCOPIC MANIFESTATIONS, POSSIBILITIES OF DRUG THERAPY

Colon lesion induced by the intake of nonsteroidal anti-inflammatory drugs (NSAIDs) (NSAID-induced colopathy) is a serious but poorly understood condition.
Objective: to investigate the incidence, clinical and endoscopic characteristics of NSAID-induced colopathy, as well as the efficacy of sulfasalazine in this pathology.
Subjects and methods. A study group consisted of 260 patients with rheumatic diseases who regularly took NSAIDs. Clinical, laboratory, and endoscopic (video colonoscopy (VCS)) examinations were carried out. Patients (n = 16) with identified NSAID-induced colopathy (erosions and ulcers of the colon) were prescribed sulfasalazine (4 g/day). A control group included 16 patients with this disease who did not receive treatment. All the patients in the study and control groups discontinued NSAIDs. The result of treatment was assessed according to VCS readings following 4 weeks.
Results and discussion. NSAID-induced colopathy was detected in 12.3% of the examined patients. It was characterized by the presence of erosions and ulcers mainly of the right colon, abdominal pain, flatulence, and diarrhea, as well as a positive fecal occult blood test. After a sulfasalazine treatment cycle, erosion and ulcer healing was noted in more than 50% of patients. The subjective manifestations of NSAID-induced colopathy were abolished in most patients. The time course of changes in endoscopic and clinical manifestations significantly differed in the study and control groups. 

Conclusion. NSAID-induced colopathy is a common disease occurring in NSAD users. Sulfasalazine may be considered as a possible treatment for NSAID-induced colopathy.

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