Resolution of multiple severe colonic strictures with prednisone therapy

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed medications with significant toxicities. Although they are best known for gastric and duodenal ulceration, they have also been implicated in the development of colonic complications including ulcerations, colitis-like syndromes and complications of diverticular disease. Further evidence links NSAID use to the development of collagenous colitis.

A rare but serious colonic complication of NSAID use is the formation of diaphragm-like strictures, most commonly in the ascending colon at the site of ulcerated haustra. A paucity of published literature exists on NSAID-associated colonic diaphragms, with only 33 cases reported in the English literature. Case reports have previously documented symptomatic resolution after the discontinuation of NSAID therapy, after endoscopic dilation or after colonic resection, but data on follow-up colonoscopy or radiology after medical or conservative management is available in only five cases. Complete healing of diaphragms has been documented only once. You deserve best quality care that costs less money than you could expect: all you need at this point is to discover very low prices on prescription drugs that do not require a prescription: buy levaquin 500 mg only here for wisest customers.

This single case of complete stricture healing followed an initial attempt at endoscopic dilation and discontinuation of NSAID use. Because this resulted in incomplete symptomatic and endoscopic resolution after three months, the stricture was redilated and prednisone therapy initiated empirically with complete resolution later observed.

In this brief communication, a case is described in which multiple NSAID-associated colonic diaphragms remained unchanged after a trial of NSAID discontinuation and 5-aminosalicylic acid therapy, but healed rapidly and completely with prednisone therapy.


Category: Prednisone therapy

Tags: Anti-inflammatory agents, Colonic diseases, Non-steroidal, Prednisone

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