Colitis lansoprazole

Gastrointestinal Of 8 patients with microscopic colitis, either lymphocytic (n = 7) or collagenous ( = 1), during treatment with lansoprazole, most were women and all were older than 60 years [57 ]. None had a history of neoplastic disorders and all were negative for celiac disease antibodies. In most cases, the symptoms started within a few weeks (median 22, range 5-180 days). In all cases, both chronological and causality likelihood scores supported a causative role of lansoprazole. In particular, withdrawal of lansoprazole and substitution of other proton pump inhibitors was followed by resolution of the bowel disorder (median 7, range 4-15 days), without need for further treatment. All were followed up for at least 4 months without symptom recurrence. 

All colonic biopsies showed erosions with severe infiltration by inflammatory cells. Masson s trichrome staining identified subepithelial collagen bands as thick as 25 pm in every specimen, consistent with collagenous colitis. Lansoprazole was withdrawn, and within a few days the watery diarrhea disappeared. Colonoscopy 2 months later showed a reduction in the number of red spots. Biopsies from the cecum, ascending, transverse, and descending colons, and rectum, showed no collagen bands. 

Microscopic lymphocytic and collagenous colitis can occur with other proton pump inhibitors, although they are more frequent with lansoprazole [48 ]. 

Di Giulio E, Delle Fave G. Lansoprazole-induced microscopic colitis an increasing problem Results of a prospective case-series and systematic review of the literature. Dig Liver Dis 2011 43 380-5. 

Onodera H, Tateno H. Linear mucosal defects a characteristic endoscopic finding of lansoprazole-associated collagenous colitis. Endoscopy 2010 42(Suppl. 2) E9-E10. 

Gastrointestinal Lansoprazole has been associated with diarrhea and microscopic colitis, but this association has not been clearly established with other proton pump inhibitors. Microscopic colitis has been reported after treatment with esomeprazole (two cases) and omeprazole (two cases) [57 ]. 

Observational studies The long-term clinical safety of dose-titrated lansoprazole 15-120 mg/day as maintenance therapy has been assessed in an open study for up to 82 months in 195 subjects who had achieved healed erosive reflux esophagitis in a phase III multicenter trial [58 ]. There were 2825 treatment-emergent adverse events in 189 subjects (97%) most of them occurred during the first year of treatment, were mild or moderate in intensity, and resolved during treatment. Of 155 serious adverse events in 74 patients, only two (colitis and rectal hemorrhage in one subject) were considered to have been treatment related. There were 187 treatment-related adverse events in 69 subjects (35%),... 

Kitagawa T, Sato K, Yokouchi Y, Tominaga K, Ito S, Maetani 1. A case of lansoprazole-associated collagenous colitis with longitudinal ulcer. J Gastrointestin liver Dis 2013 22 9. 

Konijeti GG, Deshpande V, Bunker CJ. An unusual case of chronic diarrhea. Lansoprazole-induced microscopic colitis. Gastroenterology 2013 144 696-857. 

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