Pathology of the Gastrointestinal Tract

2017 Edition
| Editors: Fátima Carneiro, Paula Chaves, Arzu Ensari

Nonsteroidal Anti-Inflammatory Drug-Induced Gastrointestinal Injury

  • Liesbeth FerdinandeEmail author
Reference work entry


Diaphragm disease


Nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal injury ranges from erosion and ulceration to more severe complications such as gastrointestinal bleeding, perforation, or bowel strictures. The association between NSAID use and ulceration in the upper gastrointestinal tract was first reported in 1938 by a gastroscopic study of Douthwaite and Lintott. Since then, this type of lesions has been well characterized and documented. Their pathogenesis is related to the inhibitory role of NSAID on cyclo-oxygenase (COX)-1 and -2, resulting in inhibition of prostaglandin synthesis. Beside the intended anti-inflammatory effect, decreased prostaglandin production can also result in gastroduodenal injury, because prostaglandins enhance and stimulate many aspects of mucosal defense. Topical irritant effects of NSAID are described to contribute to the development of erosions and ulcerations in the gastrointestinal tract. For the gastroduodenal...

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References and Further Reading

  1. Geboes, K., De Hertogh, G., & Ectors, N. (2006). Drug-induced pathology in the large intestine. Current Diagnostic Pathology, 12, 239–247.CrossRefGoogle Scholar
  2. Lang, J., Price, A. B., Levi, A. J., Burke, M., Gumpel, J. M., & Bjarnason, I. (1988). Diaphragm disease: pathology of disease of the small intestine induced by non-steroidal anti-inflammatory drugs. Journal of Clinical Pathology, 41, 516–526.CrossRefGoogle Scholar
  3. Price, A. B. (2003). Pathology of drug-associated gastrointestinal disease. British Journal of Clinical Pharmacology, 56, 477–482.CrossRefGoogle Scholar
  4. Wallace, J. L. (2012). NSAID gastropathy and enteropathy: distinct pathogenesis likely necessitates distinct prevention strategies. British Journal of Pharmacology, 165, 67–74.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PathologyGhent University HospitalGhentBelgium