Intake of non-steroidal anti-inflammatory drugs (NSAIDs) appears to be involved in some cases of isolated colitis, according to results of a retrospective study presented at the 2017 Annual Meeting of the American Society for Clinical Pathology (ASCP).
“Our results confirm previously reported limited findings of a close association of isolated colitis in the peri-appendiceal orifice region with NSAIDs,” wrote the authors, Alia Gupta, MD, and Wei Li, MD, Beaumont Hospital, Royal Oak, Michigan, at a poster session here on September 6.
“Our data further suggest that pathological changes of the isolated colitis are reversible after the cessation of the NSAIDs,” they added.
NSAIDs are known to cause gastrointestinal symptoms and histopathological changes, but limited evidence has existed as to whether isolated colitis in the peri-appendiceal orifice region is strongly associated with NSAID use.
Drs. Gupta and Li examined the clinicopathologic features of patients who had isolated colitis limited to the peri-appendiceal orifice region. The team reviewed biopsy specimens from a group of 17 such patients ranging in age from 19 to 76 years (male-to-female ratio 1.5:1).
The patients had histologically proven colitis, consisting of focal active colitis with no significant chronicity, in the cecum or peri-appendiceal orifice. The researchers found no pathological abnormalities in the terminal ileum or in other parts of the colon in any of the cases.
The team also reviewed each patient’s relevant clinical history, follow-up study, and endoscopic findings. The main endoscopic features found included erythema, focal inflammation, erosion and ulceration. Of the 17 cases in this study, 9 (53%) had histories of occasional NSAID use, and 7 (41%) had histories of routine NSAID drug intake. In 5 of the 7 patients with routine NSAID intake, the pathological abnormality resolved after the patient stopped taking the NSAIDs after repeated colonoscopy.
One patient developed lasting lower gastrointestinal tract symptoms, but no infectious disease of the gastrointestinal tract or inflammatory bowel disease was found in any of the patients after follow-up examination.
This study excluded all patients with a history of colorectal tumour or inflammatory bowel disease.