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Nonsteroidal anti-inflamatory drugs:
adverse effects in all parts of the intestine

Nonsteroidal anti-inflamatory drugs (NSAIDs) have adverse digestive effects that affect the stomach and the entire intestine, not just the duodenum.

Nonsteroidal anti-inflamatory drugs (NSAIDs) are known to have adverse effects on the stomach and duodenum, the first section of the small intestine. These adverse effects are not confined to the duodenum. The entire intestine is vulnerable to adverse effects from NSAIDs, which include perforations, ulcerations, stenosis, intestinal bleeding and acute inflammations of the colon (colitis). NSAIDs are also sometimes responsible for flare-ups in patients suffering from a chronic inflammatory disease of the intestine (Crohn’s disease and ulcerative colitis).

These adverse effects, some of which are little known, sometimes have serious clinical consequences.

All NSAIDs are implicated: the classic NSAIDs (ibuprofen, etc.), COX-2 inhibitors (celecoxib, etc.), and aspirin, even at a low dose.

These little-known adverse effects of NSAIDs are an additional reason to weigh their use carefully, and to envisage stopping them frequently, especially as the intestinal problems generally disappear when the patient stops taking NSAIDs.

©Prescrire December 2005

Source: "Effets indésirables digestifs des AINS : au-delà du duodénum aussi" Rev Prescrire 2005 ; 25 (267) : 830- 834.

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