NSAIDs can increase risk for Crohn's disease and ulcerative colitis

Inflammatory bowel diseases (IBDs) such as Crohn’s disease and ulcerative colitis are both chronic and serious health conditions. A new study was presented at the American College of Gastroenterology (ACG) 2011 Annual Scientific Meeting, which ran from October 28 through November 2 in Washington DC.

It reported that high doses of nonsteroidal anti-inflammatory drugs (NSAIDs), longer duration of use, or greater frequency of use are all associated with an increased risk for Crohn's disease and ulcerative colitis. In contrast, however, dose, duration, and frequency of aspirin use were not associated with a risk for either condition (Both aspirin and NSAIDs are associated with ulcerations in the gastrointestinal tract.).

“So this suggests that there may be pathways uniquely affected by NSAIDs and not by aspirin,” said lead author Ashwin Ananthakrishnan, MD, MPH, a gastroenterologist on staff at Massachusetts General Hospital, Boston, and an instructor at Harvard Medical School. He added, “Such pathways could potentially be important in explaining why some people get Crohn's and ulcerative colitis.”

Compared with nonusers, women who used NSAIDs for more than 15 days a month faced a greater risk for Crohn's disease and ulcerative colitis. Women who used more than five tablets of NSAIDs per week also had an elevated risk for Crohn's disease compared with women with more than six years of NSAID use. Dr. Ananthakrishnan noted that, although significant advances have been made in understanding the genetics of Crohn's disease and ulcerative colitis, with up to 99 genetic variations associated with the two diseases, genetic changes explain only about one third of the risk for the diseases, suggesting that environment has a big influence on why someone gets either Crohn's disease or ulcerative colitis.
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The study group was comprised of 76,814 women enrolled in the Nurses' Health Study (NHS). Since 1990, the NHS has obtained data on aspirin and NSAID use. Gastroenterologists subsequently confirmed diagnoses of Crohn's disease or ulcerative colitis. The data drew upon more than 18 years of data, including 123 confirmed incident cases of Crohn's disease and 117 cases of ulcerative colitis. The average age of the women in 1990 was 57 years.

Dr. Ananthakrishnan cautioned against over-interpretation of the results. He explained, “It's very important to recognize you have to weigh the risks and benefits,” noting that for someone who does not have Crohn's or ulcerative colitis, the absolute risk is fairly small. Perhaps 15 in 100,000 people risk getting the conditions.

source: examiner