Life-Threatening Diarrhea after Short-Term Misoprostol Use in a Patient with Crohn Ileocolitis
Authors: Asher Kornbluth
Journal: Annals of Internal Medicine (1990)

Brief Reports15 September 1990Life-Threatening Diarrhea after Short-Term Misoprostol Use in a Patient with Crohn IleocolitisAsher Kornbluth, MD, Rakesh Gupta, MD, Charles D. Gerson, MDAsher Kornbluth, MDSearch for more papers by this author, Rakesh Gupta, MDSearch for more papers by this author, Charles D. Gerson, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-6-474 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMisoprostol, a prostaglandin E analog, was recently approved for use in the prevention of nonsteroidal anti-inflammatory drug-induced ulcer disease. Its commonest side effects, diarrhea and abdominal cramping (1), may be attributable to the ability of prostaglandin E to stimulate small-bowel secretion (2) and motility (3). In patients with inflammatory bowel disease, prostaglandin E2 levels are elevated and such elevations may play a role in causing intestinal inflammation and diarrhea (4). We report the case of a patient with unrecognized Crohn ileocolitis who developed a nearly fatal secretory diarrhea after short-term use of misoprostol.Case ReportA 56-year-old woman was admitted...References1. HertigClay RG. Overview of clinical safety with misoprostol. Dig Dis Sci. 1985;30:185S-93S. CrossrefMedlineGoogle Scholar2. HawkeyRampton CD. Prostaglandins and the gastrointestinal mucosa. Are they important in its function, disease or treatment? Gastroenterology. 1985 ;89:1162-88. CrossrefMedlineGoogle Scholar3. PairetBouyssouRuckebusch MTV. Colonic formation of soft feces in rabbits: a role for endogenous prostaglandins. Am J Physiol. 1986;250:G302-8. MedlineGoogle Scholar4. SharonLigumskyRachmilewitzZor PMDU. Role of prostaglandins in ulcerative colitis. Enhanced production during active disease and inhibition by sulfasalazine. Gastroenterology. 1978;75:638-40. CrossrefMedlineGoogle Scholar5. LauritsenLaursenBukhaveRask-Madsen KLKJ. In vivo profiles of eicosanoids in ulcerative colitis, Crohn's colitis and Clostridium difficile colitis. Gastroenterology. 1988;95:11-7. CrossrefMedlineGoogle Scholar6. ZifroniTrevesSacharRachmilewitz AADD. Prostanoid synthesis by cultured epithelial and mononuclear cells in inflammatory bowel disease. Gut. 1983;24:659-64. CrossrefMedlineGoogle Scholar7. ShafraniMaurerThomas IWF. Prostaglandins and Crohn's disease. N Engl J Med. 1977;296:694. CrossrefGoogle Scholar8. LauritsenLaursenBukhaveRask-Marsden KLKJ. Effects of topical 5-aminosalicyclic acid and prednisolone E2 and leukotriene B4 levels determined by equilibrium in vivo dialysis of rectum in relapsing ulcerative colitis. Gastroenterology. 1986;91:837-44. CrossrefMedlineGoogle Scholar9. GoldinRachmilewitz ED. Prostanoid's cytoprotection for maintaining remission in ulcerative colitis. Failure of 15(R), 15-methylpros-taglandin E2. Dig Dis Sci. 1983;28:807-11. CrossrefMedlineGoogle Scholar10. KaufmannTaubin HH. Nonsteroidal anti-inflammatory drugs activate quiescent inflammatory bowel disease. Ann Intern Med. 1987;107:513-6. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Asher Kornbluth, MD; Rakesh Gupta, MD; Charles D. Gerson, MDAffiliations: From the Mount Sinai Medical Center, New York, New York. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImpact of colonic mucosal lipoxin A4 synthesis capacity on healing in rats with dextran sodium sulfate-induced colitisThe Role of Arachidonic Acid Regulatory Enzymes in Colorectal DiseaseStress-related mucosal disease: Risk factors and prophylactic therapyMisoprostol Therapeutics RevisitedEffects of nonsteroidal antiinflammatory drugs on inflammatory bowel disease: a case-control studyEicosanoids in Inflammatory Bowel DiseaseMassive Secretory Diarrhea and Pseudo-obstruction as the Initial Presentation of Crohn's DiseaseActions of sulphasalazine and analogues on mucosal eicosanoid formation and metabolism in patients with ulcerative colitisProphylaxis against NSAID‐induced ulcersProfuse Diarrhea after Misoprostol Use in a Patient with a History of Crohn's DiseaseInflammatory bowel disease part I: Nature and pathogenesisPostmarketing Surveillance: Lessons LearnedDiarrhea after Misoprostol in Crohn DiseaseGerald A. Faich, MD, MPH, Myra F. Frick, Harris Koffer, PharmD 15 September 1990Volume 113, Issue 6Page: 474-475KeywordsDiarrheaDrugsInflammatory bowel diseaseIntestinal inflammationProstaglandinUlcers ePublished: 1 December 2008 Issue Published: 15 September 1990 PDF downloadLoading ...