Step I Inflammatory Bowel Disease

[Alde8127]

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I am slightly confused as to how NSAIDs can cause Crohn’s disease as I thought NSAIDs block the production of COX 1 and COX 2, thus preventing inflammation – but Crohn’s is an inflammatory disease.

Could someone please explain this to me.

Thanks 🙂

 

[Lannister]

I would guess that it's like peptic ulcer disease. Prostaglandins contribute to the protective lining of your intestines, so if you are inhibiting prostaglandin synthesis with NSAIDs, you are destroying that protective barrier, leaving the intestines open to more damage.

 

[Alde8127]

I would guess that it's like peptic ulcer disease. Prostaglandins contribute to the protective lining of your intestines, so if you are inhibiting prostaglandin synthesis with NSAIDs, you are destroying that protective barrier, leaving the intestines open to more damage.

That does kinda make sense

 

[The Knife & Gun Club]

I would guess that it's like peptic ulcer disease. Prostaglandins contribute to the protective lining of your intestines, so if you are inhibiting prostaglandin synthesis with NSAIDs, you are destroying that protective barrier, leaving the intestines open to more damage.

Yup, thats the gist of it.

Although paradoxically the first line treatment for Ulcerative Colitis is 5-ASA (aspirin derivative), which works by blocking COX1 & 2 lol.

 

[Alde8127]

Yup, thats the gist of it.

Although paradoxically the first line treatment for Ulcerative Colitis is 5-ASA (aspirin derivative), which works by blocking COX1 & 2 lol.

So how come this works for ulcerative colitis? Is it something to do with the fact that just the mucosa is damaged?

 

[The Knife & Gun Club]

So how come this works for ulcerative colitis? Is it something to do with the fact that just the mucosa is damaged?

Yea it has to do with that 5-ASA has virtually 0 systemic absorption and needs to be metabolized by enterocytes + have a high pH to exert its effect. So its targeted only to the superficial layers of the mucosa. The mechanism isn't really very well understood.

I actually have ulcerative colitis and thats how my Dr. explained it to me. But personal experience - I go a day without 5-ASA and its pretty bad.

If I accidentally take an ibuprofen instead of a Tylenol, its apocalyptic. So whatever the reason, it is a real thing lol.

 

[Alde8127]

Thank you for sharing your personal experience and for the explanation about 5-ASA 🙂