Colon
Drug induced colitides
NSAID associated colitis
Author: Hanni Gulwani, M.B.B.S.
Last author update: 1 May 2013
Last staff update: 3 May 2022
Copyright: 2003-2025, PathologyOutlines.com, Inc.
PubMed Search: NSAID associated colitis
Table of Contents
Definition / general | Clinical features | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Gulwani H. NSAID associated colitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colonnsaid.html. Accessed April 1st, 2025.
Definition / general
- Associated with bleeding, diarrhea, abdominal pain, although usual side effects are subclinical (Am J Med Sci 2009;338:96)
Clinical features
- Endoscopy: small erosions in different parts of colon (Pathologe 2006;27:65, Hum Pathol 2007;38:527)
- Colonoscopy findings may be normal, inflammation, superficial ulcers, solitary / multiple deep ulcers (Indian J Gastroenterol 2009;28:150)
Case reports
- 39 year old man with NSAID induced colopathy misinterpreted as Crohn's disease (Z Gastroenterol 2010;48:472)
- 3 cases: rofecoxib and inflammatory bowel disease (J Clin Gastroenterol 2005;39:142)
Treatment
- Discontinuation of NSAIDs (Z Gastroenterol 2000;38:957)
- Selective COX2 inhibition may be an alternative to NSAIDs in rheumatologic patients (Gastroenterol Clin North Am 2009;38:333)
Microscopic (histologic) description
- Usually mixed inflammatory infiltrate but may be predominantly neutrophilic or lymphocytic (Am J Clin Pathol 1998;110:622, Adv Anat Pathol 1999;6:213)
- Often erosions, crypt architectural disarray; no granulomas
- Incidental chronic colitis: cecal based chronic colitis associated with frequent NSAID use; basal plasmacytosis (94%) or crypt architectural distortion (94%) often disappears after NSAID withdrawal (Am J Surg Pathol 2010;34:463)
Microscopic (histologic) images
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Ulcer post NSAID therapy
Differential diagnosis
