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
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.
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.
- 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.