Colon ulceration

The a-glucosidase inhibitors are contraindicated in patients with a hypersensitivity to the drug, diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to intestinal obstruction, or chronic intestinal diseases. Acarbose and miglitol are used cautiously in patients with renal impairment or pre-existing gastrointestinal (GI) problems such as irritable... 

Diabetic ketoacidoses inflammatory bowel disease colonic ulceration partial intestinal obstruction patients predisposed to intestinal obstruction chronic intestinal diseases associated with marked disorders of digestion or absorption or with conditions that may deteriorate as a result of increased gas formation in the intestine hypersensitivity to the drug or any of its components. 

Irritation in the colon can also initiate intense mass movements. For example, a person who has an ulcerated condition of the colon (ulcerative colitis) frequently has mass movements that persist almost all of the time. 

Kayexalate (sodium polystjrene sulfonate) in sorbitol is commonly used to treat hjrperkalemia in patients with renal insufficiency. Case reports have documented intestinal necrosis after the administration of kayexalate in sorbitol (26,27). In one study, there was an incidence of 1.8%, and the authors concluded that sorbitol-associated complications may not be uncommon postoperatively (28). Furthermore, it has been suggested that some cases of idiopathic colonic ulcers in patients with renal failure are due to the effects of sorbitol. While kayexalate crystals, which are purple, irregular, and jagged, can be an incidental finding and are not known to cause injury, they are a helpful histological clue to the possibility that sorbitol has been administered (29). 

Colonic stricture, similar to ileum diaphragm disease, developed in a patient during prolonged administration of modified-release diclofenac (12). Pseudomembranous colitis and colonic ulceration, with or without a diaphragm-like colonic stricture, have been reported (SEDA-16, 110) (SEDA-17, 109). Dispersible diclofenac is a formulation from which absorption is more rapid than... 

Colonic ulceration with massive bleeding has been reported in a woman who received ketorolac intramuscularly (SEDA-21,106). 

Colonic ulceration has been attributed to the use of hydrogen peroxide in an enema (44). 

Bollen P, Goossens A, Hauser B, Vandenplas Y. Colonic ulcerations caused by an enema containing hydrogen peroxide. J Pediatr Gastroenterol Nutr 1998 26(2) 232-3. 

In a retrospective study of NSAID-induced colonic ulceration related to NSAID therapy, five of 14 patients were taking loxoprofen (1). However, this finding does not prove that loxoprofen is more ulcerogenic than other NSAIDs. 

When administered long-term, the fenamates cause watery diarrhea in more patients than other NSAIDs. Although colonic ulceration has been reported after oral ingestion of several NSAIDs (SEDA-7, 105) (SEDA-10, 77) (SEDA-15, 95), the evidence is not entirely convincing. On the other hand, there is firm reason to conclude that there is a direct causal relation between rectally administered NSAID and rectal ulceration, which seems to occur more frequently when doses are high or treatment is prolonged. 

Ulcerative colitis. A disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers... 

Ulcerative cohtis involves the rectum and extends proximally to all or different portions of the colon (ulcerative proctitis, sigmoiditis, left-sided cohtis or pancolitis). Rectosigmoid involvement is present in almost all patients at endoscopy, with approximately 40-50%ofpatientshavingdiseaselimitedtotherectum... 

Watson MA, Baker TP, Nguyen A, SebastianelH ME, Stewart HE, Oliver DK, et al. Association of prescription of oral sodium polystyrene sulfonate with sorbitol in an inpatient setting with colonic necrosis a retrospective cohort study. Am J Kidney Dis September 2012 60(3) 409-16. [97] Albeldawi M, Gaur V, Weber L. Kayexalate-induced colonic ulcer. Gastroenterol Rep (Oxf) August 2014 2(3) 235-6. 

Chelcun JL, Sable RA, Friedman K. Colonic ulceration in a patient with renal disease and hyperkalemia. JAAPA October 2012 25(10) 34, 37-8. 

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