Pathological effects of drugs on the gastrointestinal tract: a review

Hum Pathol. 2007 Apr;38(4):527-36. doi: 10.1016/j.humpath.2007.01.014.


Drug-induced injury of the gastrointestinal (GI) tract is increasingly common but generally under-recognized. Although there is an overwhelming number of drugs that are associated with adverse GI effects, there is a limited number of characteristic injury patterns that should prompt consideration of drug-induced GI pathology. These include the following: erosions, ulcers, and strictures; crystal deposition; parietal cell changes; reactive gastropathy; pseudodysplastic changes; microscopic colitis; infectious or necrotizing enterocolitis; ischemic colitis; focal active colitis; and increased epithelial apoptosis. This article reviews morphological and pathophysiological features of some of the more common and pathologically recognizable drug-related injury patterns and provides a practical guide for the recognition and diagnosis of drug-induced pathology in the upper and lower GI tract.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alendronate / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Apoptosis / drug effects
  • Colitis / chemically induced
  • Drug-Related Side Effects and Adverse Reactions*
  • Enterocolitis, Necrotizing / chemically induced
  • Esophagitis / chemically induced
  • Gastritis / chemically induced
  • Gastrointestinal Tract / drug effects*
  • Gastrointestinal Tract / pathology*
  • Humans
  • Intestinal Mucosa / cytology
  • Intestinal Mucosa / drug effects
  • Iron / adverse effects
  • Parietal Cells, Gastric / drug effects
  • Polystyrenes / adverse effects
  • Proton Pump Inhibitors
  • Stomach Ulcer / chemically induced


  • Anti-Inflammatory Agents, Non-Steroidal
  • Polystyrenes
  • Proton Pump Inhibitors
  • polystyrene sulfonic acid
  • Iron
  • Alendronate