Gerald A. Faich, MD, MPH; Myra F. Frick; Harris Koffer, PharmD
To the Editors: We read with interest the report by Kornbluth and colleagues (1) describing severe diarrhea after exposure to misoprostol in a woman with a history of ileocolitis. The authors conclude that "misoprostol be used with extreme caution in patients with known inflammatory bowel disease."
Prostaglandins do not appear to be critical mediators in the production of inflammation and ulcerative colitis; rather, they are present in increased quantities as a consequence of ongoing inflammation (2). Animal studies have shown that prostaglandin E2 and misoprostol provide a protective effect against colonic irritants (3-5).
To examine the incidence and severity of
Faich GA, Frick MF, Koffer H. Diarrhea after Misoprostol in Crohn Disease. Ann Intern Med. 1991;114:342. doi: 10.7326/0003-4819-114-4-342_2
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Published: Ann Intern Med. 1991;114(4):342.
Diarrhea, Gastroenterology/Hepatology, Inflammatory Bowel Disease.
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