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Related Experiment Videos

Can NSAIDs cause acute biliary pain with cholestasis?

H L Waldum1, T Hamre, P M Kleveland

  • 1Department of Medicine, University Hospital, Trondheim, Norway.

Journal of Clinical Gastroenterology
|June 1, 1992
PubMed
Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs), including paracetamol, can cause acute biliary pain and liver issues in some individuals. A detailed drug history is crucial for diagnosing these NSAID-induced episodes, especially when other tests are normal.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Clinical Pharmacology

Background:

  • Biliary pain and elevated liver function tests (LFTs) can have various causes.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used analgesics and anti-inflammatory agents.
  • The role of NSAIDs, particularly paracetamol, in acute biliary events is not fully elucidated.

Observation:

  • Two patients experienced recurrent acute biliary pain and abnormal LFTs 12-48 hours after NSAID ingestion.
  • One patient had a known NSAID intolerance, but paracetamol was not previously suspected.
  • Combined use of paracetamol and codeine appeared to exacerbate symptoms in one patient.

Findings:

  • NSAIDs, including paracetamol, can precipitate acute biliary pain and transient LFT abnormalities.

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  • These NSAID-induced episodes may occur even with normal endoscopic cholangiography findings.
  • Paracetamol, alone or in combination with codeine, may contribute to the severity of biliary events.

    • Implications:

    • Clinicians should consider NSAIDs as a potential cause of biliary pain and LFT abnormalities, especially in patients with normal endoscopic evaluations.
    • A comprehensive drug history, specifically inquiring about NSAID use, is essential for accurate diagnosis and management.
    • Further research may clarify the mechanisms and prevalence of NSAID-induced biliary dysfunction.