Drug Induced Damage

All commonly used non-steroidal anti-inflammatory drugs (NSAIDs), apart from aspirin and nalbumetone, are associated with increased intestinal permeability in man. Whilst reversible in the short term, it may take months to improve following prolonged NSAID use102. NSAIDs cause quite distinct and severe biochemical damage during drug absorption, with the uncoupling of mitochondrial oxidative phosphorylation proving to be most important. Different NSAIDs and different preparations of the same NSAID may have different effects on small bowel permeability103

Small bowel ulceration connected to the use of slow-release potassium chloride tablets has been reported104. Most were associated with of 1-2 cm of stenosis, and a significant fraction with perforation of the bowe,l and the mortality rate was 27%. These problems many be reduced if wax-matrix or microencapsulated preparations of potassium chloride are used which slowly release potassium and chloride ions over time105.

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