Drug induced damage in the
effect on pre-existing disease:-
NSAIDs associated with
GI hemorrhage, perforation, and fistulous tract formation.
exacerbating preexisting inflammatory bowel disease (IBD).
Analgesics may bring about relapse of ulcerative colitis.
Immunosuppressive drugs in IBD may
(Example: Cytomegalo virus.)
2. Cause de novo disease:
- Ulceration &
Solitary, non- specific
ulcers, usually present in the caecum following use of NSAIDs - (oxyphen butazone,
diclofenac, ibuprofen), in the distal colon (naproxen,aspirin and phenylbutazone)
and anorectal region (indomethacin).
- Stricures and diaphragm disease :
NSAIDs: Toxic megacolon
- Mucosal necrosis:
Kayexalate (sodium polystyrene sulfonate) in sorbitol.
necrosis of the GIT.
Administered orally or by enema in the treatment
Resected, long segments of colon and rectum may be
Associated with drugs that predispose to thrombosis (oral
contraceptives, estrogen) and drugs that cause vasoconstriction
Histologically, characterized by damaged
epithelium, decreased mucin and small shrunken crypts, dense pink
lamina propria and relatively little inflammation.
Endoscopy may give
rise to mucosal damage in colon.
Glutaraldehyde (to cleanse
sterilize endoscopes) may produce colitis with ischaemic features.
Indian ink and methylene blue (mark areas of colorectal mucosa during endoscopy) may produce ischaemia.
associated with a number of drugs - diclofenac, naproxen, and
Acute colitis is characterized by neutrophils in the
lamina propria and epithelium associated with reactive epithelial
changes but with minimal chronic inflammation or crypt distortion.