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Adverse effects of drugs on small intestine and colon

Zeino Zeino1, Guy Sisson, Ingvar Bjarnason

  • 1Department of Gastroenterology, King's College Hospital, Denmark Hill, London SE5 9RS, UK. Zeino.Zeino@kch.nhs.uk

Best Practice & Research. Clinical Gastroenterology
|March 16, 2010
PubMed

Insights

Drug side effects commonly impact the small and large intestine, causing 20-40% of all adverse drug reactions. Awareness is key for diagnosing these drug-induced intestinal issues, which have complex mechanisms and varied clinical presentations.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Internal Medicine

Background:

  • The small and large intestine are frequent sites of drug-induced adverse events, representing 20-40% of all drug side effects.
  • Mechanisms of drug-induced intestinal damage are complex, involving topical effects, altered motility or secretion, immune suppression, or cytotoxic actions.

Purpose of the Study:

  • To highlight the significance of awareness in diagnosing drug-induced intestinal side effects.
  • To review the diverse mechanisms and clinical presentations of drug-induced intestinal damage.
  • To discuss diagnostic approaches, including drug withdrawal and capsule enteroscopy.

Main Methods:

  • Literature review of drug-induced intestinal side effects.
  • Analysis of mechanisms, clinical manifestations, and diagnostic strategies.
  • Case examples illustrating the spectrum of drug-induced enteropathy.

Main Results:

  • Drug-induced intestinal side effects range from mild (constipation from tricyclic antidepressants) to severe (enteropathy from NSAIDs, docetaxene).
  • Specific drug classes like NSAIDs, cytotoxic agents, statins, and antiretrovirals are associated with distinct intestinal pathologies.
  • Diagnosis traditionally relies on symptom improvement after drug cessation, with capsule enteroscopy emerging as a valuable diagnostic tool.

Conclusions:

  • Physician awareness is paramount for diagnosing drug-induced intestinal conditions.
  • A comprehensive understanding of drug pharmacology and potential intestinal toxicities is crucial.
  • Capsule enteroscopy offers a novel approach to diagnosing drug-induced intestinal damage when traditional methods are insufficient.

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