Drug-induced Gastrointestinal Disorders

Linda G. Tolstoi, RPh, MS, MEd

June 26, 2002

Abstract and Introduction

Abstract

The gastrointestinal tract is frequently the site of complications resulting from prescription and over-the-counter drug use. If unrecognized or untreated, over time, these complications have the potential to affect nutritional status. Healthcare professionals need to be aware of the drugs commonly implicated in causing gastrointestinal complaints in order to prevent long-term complications. Patients should be alerted to the early warning signs of drug-induced gastrointestinal disorders so that they can seek care and prevent long-term complications.

Introduction

In the United States, the 1.5 billion or more prescriptions dispensed each year play an important role in managing disease.^[1] However, medications are associated with an increasing incidence of drug-induced (iatrogenic) complications. The gastrointestinal tract (GI) is frequently the site of such complications.^[1] According to one study, the gastrointestinal tract was associated with 20% to 40% of the drug-induced adverse effects.^[2]

Many gastrointestinal side effects, such as nausea, vomiting, dyspepsia, abdominal cramps, diarrhea, or constipation, occur without any identifiable lesion or cause.^[1] Usually, these effects are transient and resolve shortly after the drug is discontinued. However, there are some widely prescribed drugs that cause serious and lasting adverse effects (mucosal ulceration, stricture, or increased susceptibility to pseudomembranous colitis).^[1,3] In some situations, the adverse effects are worse than the illness for which the drug was prescribed.^[1]

This review provides an overview of some common drug-induced gastrointestinal effects. Over time, these adverse effects may impact a patient's nutritional status. The elderly are most susceptible to these effects.

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Table 1. Table 1. Precautions to Prevent Irritation of the Esophagus
Swallow several sips of water to lubricate the throat before taking a tablet or capsule. Swallow tablet or capsule with at least 8 ounces of liquid. Swallow tablets or capsules while in an upright or sitting position. Do not lie down immediately after taking a tablet or capsule to ensure that the solid dosage forms pass through the esophagus and into the stomach. Inform your physician if swallowing continues to be painful or if the tablets or capsules continue to stick in the throat.

Table 2. Table 2. Warning Signs of Delayed Gastric Emptying
Nausea Bloating Feeling of fullness Vomiting of food many hours after eating Mid-abdominal pain Heartburn/indigestion Sensation of food regurgitating into the throat

Table 3. Table 3. Warning Signs of NSAID-induced Gastric Irritation
Severe abdominal cramps/pain Burning in the stomach or back Blood in the stools Bloody vomit Severe heartburn/indigestion Diarrhea

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Drug-induced Gastrointestinal Disorders

Abstract and Introduction

Abstract

Introduction

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

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