The spectrum of drug-related colitides: important entities, though frequently overlooked

Dig Liver Dis. 2011 Jul;43(7):523-8. doi: 10.1016/j.dld.2010.12.016. Epub 2011 Feb 15.


Background: There is at present a relative lack of knowledge concerning drug-related colitides, although these may be not infrequent entities in clinical practice.

Aims: To assess the frequency and the clinical-pathological subtypes of drug-related colitides in a gastrointestinal pathology referral centre.

Methods: All charts of endoscopic biopsy samples referred for colitis in a eight-year period were reviewed. To be classified as drug related colitis, patients' charts should report the use of any drug in a two month period before colonoscopy and no other obvious cases of colitis be present. For analysis, we considered only patients taking one drug in this period.

Results: We found 122 cases of drug-related colitis out of 3877 charts reviewed (3% of the overall colitis group). These cases were represented by microscopic colitis (50%), eosinophil rich infiltrate of the left colon (34%), ischemic colitis (11%), pseudomembranous colitis (3%), apoptotic colopathy (2%). The drugs most frequently associated with these colitides were represented by non-steroidal anti-inflammatory drugs.

Conclusion: It is important to raise awareness concerning drug-related colitides, to avoid diagnostic errors and provide a better therapeutic approach to patients with these conditions.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Biopsy
  • Colitis / chemically induced
  • Colitis / pathology*
  • Colonoscopy / methods*
  • Diagnosis, Differential
  • Diagnostic Errors / prevention & control
  • Humans
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / pathology
  • Middle Aged
  • Retrospective Studies


  • Anti-Inflammatory Agents, Non-Steroidal