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Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Peptic Ulcer Disease III: Clinical Manifestations and Complications01:25

Peptic Ulcer Disease III: Clinical Manifestations and Complications

Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant use.Gastric UlcersGastric ulcers share...
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...

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Chronic Salmonella Infection Induced Intestinal Fibrosis
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Published on: September 22, 2019

NSAID-related gastrointestinal complications.

A H Soll1, D McCarthy

  • 1CURE-UCLA Digestive Disease Center, USA.

Clinical Cornerstone
|February 22, 2000
PubMed
Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause serious gastrointestinal complications. Reducing NSAID use and considering newer cyclo-oxygenase (COX)-2 inhibitors may lower risks, though clinical outcomes need further study.

Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) frequently cause gastrointestinal (GI) complications, including bleeding and perforation.
  • The pathogenesis and optimal management of NSAID-induced GI injury remain incompletely understood.
  • The term "NSAID gastropathy" broadly encompasses various distinct mucosal lesions, hindering precise clinical investigation.

Purpose of the Study:

  • To review the pathogenesis and management of NSAID-induced GI complications.
  • To provide general guidelines for the prevention of these complications.
  • To discuss unresolved issues, such as the role of Helicobacter pylori and the impact of newer NSAIDs.

Main Methods:

  • Literature review and synthesis of current knowledge on NSAID-induced GI injury.

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  • Discussion of mechanisms involving platelet effects and mucosal lesions.
  • Analysis of clinical implications of different NSAID classes.

    • Main Results:

    • NSAID complications stem from direct mucosal damage and impaired platelet function, affecting the esophagus, stomach, and duodenum.
    • Pre-existing ulcers and NSAID-induced lesions contribute to bleeding risk.
    • Cyclo-oxygenase (COX)-2 selective inhibitors show reduced endoscopic ulcer risk and minimal platelet effects compared to traditional NSAIDs.

    Conclusions:

    • Reducing or eliminating NSAID exposure is the primary management strategy.
    • Differentiating between various NSAID-induced mucosal lesions is crucial for effective clinical investigation and management.
    • While newer COX-2 inhibitors appear safer endoscopically, their definitive clinical benefit in reducing GI complications requires further establishment.