Non-steroidal anti-inflammatory drugs and segmental non-gangrenous colitis

Objective To determine, in a case-control study, whether exposure to non-steroidal anti-inflammatory drugs (NSAIDs) was associated with segmental non-gangrenous colitis. Methods One hundred and sixteen consecutive patients with segmental non-gangrenous colitis were compared with 232 age- and gender-matched hospital controls (two controls for each patient). Data on past medical history and use of drugs within 30 days before admission were collected using a standardized questionnaire administered to each patient. Results Twenty patients (17.2%) and eight controls (3.4%) were taking NSAIDs on admission (P < 0.0001). Nineteen out of 20 patients and only two out of eight controls had used NSAIDs within the last 30 days before admission (P < 0.005). The association between NSAIDs and segmental non-gangrenous colitis was significant in patients over 60 years of age (P < 0.0001) but not in those under 60 years (P = 0.4) even if in the latter group, the percentage of NSAIDs users among patients with segmental non-gangrenous colitis was twice as high as in controls. For all considered criteria except NSAIDs, comparison between both groups showed that only the use of digitalis was significantly greater in patients than in controls (P < 0.05). Conclusions The association between use of NSAIDs and segmental non-gangrenous colitis may be causal. The mechanism by which NSAIDs may cause this condition remains unclear and may not be univocal.