Case Report
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World J Gastroenterol. Jan 14, 2013; 19(2): 299-303
Published online Jan 14, 2013. doi: 10.3748/wjg.v19.i2.299
Lubiprostone induced ischemic colitis
Muhammed Sherid, Humberto Sifuentes, Salih Samo, Parakkal Deepak, Subbaramiah Sridhar
Muhammed Sherid, Salih Samo, Department of Internal Medicine, Division of Gastroenterology, Saint Francis Hospital, Evanston, IL 60202, United States
Humberto Sifuentes, Subbaramiah Sridhar, Section of Gastroenterology and Hepatology, Medical College of Georgia, Georgia Health Sciences University, Augusta, GA 30912, United States
Parakkal Deepak, Department of Internal Medicine, Division of Gastroenterology, NorthShore University HealthSystem, Highland Park, IL 60035, United States
Author contributions: Sherid M contributed to Study design, case presenter, literature review, data collection, data analysis, initial manuscript writing, manuscript review, approval of final version; Sifuentes H, Samo S, Deepak P, Sridhar S contributed to study design, literature review, data collection, data analysis, initial manuscript writing, manuscript review, approval of final version.
Correspondence to: Subbaramiah Sridhar, MBBS, MPH, FRCP (Edin), FRCP (Glasg), FRSS (Lond), FRCPC (Med and Gastro), FASGE, FACP, FACG, FASLM and S (United States), FAAG, MAAG, Professor of Medicine, Section of Gastroenterology and Hepatology, Medical College of Georgia, Georgia Health Sciences University, Augusta, GA 30912, United States. ssridhar@georgiahealth.edu
Telephone: +1-706-7212238 Fax: +1-706-7210331
Received: August 27, 2012
Revised: October 30, 2012
Accepted: November 6, 2012
Published online: January 14, 2013
Abstract

Ischemic colitis accounts for 6%-18% of the causes of acute lower gastrointestinal bleeding. It is often multifactorial and more commonly encountered in the elderly. Several medications have been implicated in the development of colonic ischemia. We report a case of a 54-year old woman who presented with a two-hour history of nausea, vomiting, abdominal pain, and bloody stool. The patient had recently used lubiprostone with close temporal relationship between the increase in the dose and her symptoms of rectal bleeding. The radiologic, colonoscopic and histopathologic findings were all consistent with ischemic colitis. Her condition improved without any serious complications after the cessation of lubiprostone. This is the first reported case of ischemic colitis with a clear relationship with lubiprostone (Naranjo score of 10). Clinical vigilance for ischemic colitis is recommended for patients receiving lubiprostone who are presenting with abdominal pain and rectal bleeding.

Keywords: Lubiprostone, Ischemic colitis, Gastrointestinal bleeding, Rectal bleeding, Colonoscopy