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Possible association between statin use and bowel dysmotility
Roland Fernandes1, Irshad Shaikh, Henk Wegstapel
1Vascular Surgery Department, Medway Maritime Hospital, Kent, UK. rfernandes@doctors.org.uk
BMJ Case Reports
|June 6, 2012
Summary
Statins, used for lowering cholesterol, may cause colon motility issues. Discontinuing statins relieved symptoms of colonic dilatation and volvulus in a patient, with recurrence upon restarting the medication.
Area of Science:
- Pharmacology
- Gastroenterology
- Clinical Medicine
Background:
- 3-Hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) effectively lower serum lipid levels.
- Potential side effects include liver dysfunction, renal failure, and myopathy.
- Statins may influence nitric oxide (NO) levels by upregulating nitric oxide synthase.
Observation:
- Nitric oxide is implicated in impairing colonic motility via inhibitory nerves.
- A case of recurrent colonic dilatation and volvulus is presented.
- Initial treatment with sigmoid colectomy did not resolve symptoms.
Findings:
- Omitting statins led to symptomatic relief in a patient with recurrent colonic issues.
- Restarting statins inadvertently caused symptom recurrence.
- Discontinuation of statins resulted in sustained symptomatic benefit.
Implications:
- Statins may play a role in the pathophysiology of colonic motility disorders.
- This case highlights the importance of considering medication side effects in unexplained gastrointestinal symptoms.
- Further research into the link between statins, nitric oxide, and colonic function is warranted.
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