Help - need Dr. Shen article on NSAID and pouchitis

ElmerFuddMember

Hey all,

Do any of you know if / where there is an article by Dr. Shen specifically on NSAID induced pouchitis? I have searched before and found presentations and papers that mention multiple examples of pouchitis and note pictures of someone with NSAID induced pouchitis.

If not, can any of you that are his patients with his email see if he has written anything specific on this topic?

I have a very difficult time getting other doctors to understand this is a real issue for us when we stay on NSAIDs for prolonged periods of time. Some docs flat out refute the fact, while others tell me they don't believe that is correct because in a normal patient it can irritate the stomach and/or colon but not the ileal tissue where NSAIDs reside for a period of time (meaning, because they are in transit in ileal tissue they won't cause the problem - kind of missing the whole ileal "pouch" idea).

Anyway, it would be great to have an article in hand to help explain this.

Thanks!
Steve

9/14/129:49 AM

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Jan DollarModerator, RN, retired

Not sure why your doctors are so resistant to this concept, since it has been known for decades that NSAIDs can have a negative impact on the course of IBD. My rheumatologist initially thought it would be OK to continue with them as long as I took Prilosec. But between the pouchitis and liver inflammation, I had to let them go. I still take them occasionally for about two weeks if I have a flare, just to avoid prednisone.

The fact that you have had a colectomy does not mean you no longer are susceptible to IBD. Even non-IBD patients can suffer significant GI distress, inflammation, and bleeding, and not just in the stomach. With the advent of the camera pill endoscopy, this has been proven. http://www.ncbi.nlm.nih.gov/pubmed/15645405

Anyway, here is a link to the abstract of Dr. Shen's article about NSAIDs and pouchitis. Basically, it says that any of the patients in the study that had pouchitis and were taking NSAIDs, discontinuing them improved the symptoms in ALL of them.
http://www.ncbi.nlm.nih.gov/pubmed/17410449

This does not mean that NSAIDs always cause pouchitis, but if you have pouchitis and are taking NSAIDs, you should have a high level of suspicion that they are the culprit, or at least a contributing factor.

Jan

9/14/1211:13 AM

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TinCanMember

If you desire the full article, I'm sure you can obtain it via a subscription to uptodate (http://www.uptodate.com/index). The cost is quite reasonable given the amount of information available.

9/15/126:06 AM

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