Ann Intern Med  1987 Oct;107(4):513-6 

Nonsteroidal anti-inflammatory drugs activate quiescent inflammatory bowel

disease.

Kaufmann HJ, Taubin HL.

Four patients with quiescent inflammatory bowel disease had prompt exacerbations

when given nonsteroidal anti-inflammatory drugs. Nonsteroidal anti-inflammatory

drugs can have noxious effects on the distal intestine as well as on the

proximal gut. Eight previous cases of exacerbation of ulcerative colitis have

been reported, as have instances of de-novo colitis and ileitis in persons

treated with nonsteroidal anti-inflammatory drugs who did not have preexisting

inflammatory bowel disease. Nonsteroidal anti-inflammatory drug ingestion should

be considered in the differential diagnosis of inflammatory bowel disease. These

drugs should be administered to patients with inflammatory bowel disease only

after consideration of their possible harmful effects.