Abstract
The phenomenon of strictures of the colon induced by nonsteroidal anti-inflammatory drugs is a newly recognized pathologic entity that has gained little exposure in the surgical literature to date. A further case is reported and the clinical features of this entity are discussed. Most patients present with symptoms suggestive of malignancy, namely anemia, obstructive symptoms, or weight loss. Pathologic changes are characterized by diaphragm-like strictures with submucosal fibrosis. Surgical resection to exclude malignancy and treat symptoms along with cessation of the nonsteroidal anti-inflammatory drug is the treatment of choice.
Similar content being viewed by others
References
Sheers R, Williams WR. NSAIDs and gut damage [letter]. Lancet 1989;2:1154.
Huber T, Ruchti C, Halter F. Nonsteroidal antiinflammatory drug induced colonic strictures: a case report. Gastroenterology 1991;100:1119–22.
Monahan DW, Stames EC, Parker AL. Colonic strictures in a patient on long-term nonsteroidal anti-inflammatory drugs. Gastrointest Endosc 1992;38:385–8.
Fellows IW, Clarke JM, Roberts PF. Nonsteroidal anti-inflammatory drug-induced jejunal and colonic diaphragm disease: a report of two cases. Gut 1992;33:1424–6.
Whitcombe DC, Martin SP, Trellis DR, Evans BA, Becich MJ. “Diaphragmlike” stricture and ulcer of the colon during diclofenac treatment. Arch Intern Med 1992;152:2341–3.
Haque S, Haswell JE, Dreznick JT, West AB. A cecal diaphragm associated with the use of nonsteroidal anti-inflammatory drugs. J Clin Gastroenterol 1992;15:332–5.
Pucius RJ, Charles AK, Adair HM, Rowe RC, Hacking JC. Diaphragm-like strictures of the colon induced by nonsteroidal anti-inflammatory drugs. Br J Surg 1993;80:395–6.
Halter F, Weber B, Huber T, Eigenmann F, Frey MP, Ruchti C. Diaphragm disease of the ascending colon: association with sustained release diclofenac. J Clin Gastroenterol 1993;16:74–80.
Robinson MH, Wheatley T, Leach IH. Nonsteroidal antiinflammatory drug-induced colonic stricture. An unusual cause of large bowel obstruction and perforation. Dig Dis Sci 1995;40:315–9.
Gargot D, Chaussade S, d'Alteroche L,et al. Nonsteroidal anti-inflammatory drug-induced colonic strictures: two cases and literature review. Am J Gastroenterol 1995;90:2035–8.
Hooker GD, Gregor JC, Ponich TP, McLarty TD. Diaphragm-like strictures of the right colon induced by indomethacin suppositories: evidence of a systemic effect. Gastrointest Endosc 1996;44:199–202.
Eis MJ, Watkins BM, Philip A, Welling RE. Nonsteroidal induced benign strictures of the colon: a case report and review of the literature. Am J Gastroenterol 1998;93:120–1.
Puspok A, Kiener HP, Oberhuber G. Clinical, endoscopic and histologic spectrum of nonsteroidal anti-inflammatory drug-induced lesions in the colon. Dis Colon Rectum 2000;43:685–91.
Lang J, Price AB, Levi AJ, Burke M, Gumpel JM, Bjarnson I. Diaphragm disease: pathology of disease of the small intestine induced by nonsteroidal antiinflammatory drugs. J Clin Pathol 1988;41:516–26.
Davies NM. Toxicity of nonsteroidal anti-inflammatory drugs in the large intestine. Dis Colon Rectum 1995;38:1311–21.
Author information
Authors and Affiliations
About this article
Cite this article
Israel, L.H., Koea, J.B., Stewart, I.D. et al. Nonsteroidal anti-inflammatory drug-induced strictures of the colon. Dis Colon Rectum 44, 1362–1364 (2001). https://doi.org/10.1007/BF02234797
Issue Date:
DOI: https://doi.org/10.1007/BF02234797