Nonsteroidal anti-inflammatory drug-induced Enteritis: a case report

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most prescribed medications worldwide, mainly for the treatment of osteoarthritis, musculoskeletal pain, rheumatoid arthritis and other inflammatory conditions. They act by inhibiting the activity of cyclooxygenase (COX) enzymes, resulting in the blockage of the genesis of prostaglandins, prostacyclins and thromboxanes. These blockages predispose the appearance of adverse effects such as acute lesions of the gastroduodenal mucosa, ulcers, esophagitis, enteritis, reactivation of inflammatory bowel diseases, among others. NSAIDs have deleterious effects that can affect the whole mucosa of the gastrointestinal tract. As in the stomach, the intestine, especially the distal small intestine and colon, is susceptible to the various deleterious effects of anti-inflammatory drugs, with the ileocecal region being the most commonly affected, which may have erosions, ulcers, stenoses, perforations, and formation of diaphragms, which can lead to intestinal obstruction. We report the case of a 33-year-old male patient, who used chronic and abusive NSAIDs, hospitalized for distension and abdominal pain, nausea, vomiting and diarrhea. During the investigation, after investigated the most frequent causes of these symptoms, he was diagnosed with enteritis, with formation of subestenoses, due to the abusive and chronic use of NSAIDs. A review of the clinical and diagnostic aspects of enteropathy induced by NSAID is performed.