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Life-Threatening Diarrhea after Short-Term Misoprostol Use in a Patient with Crohn Ileocolitis

Asher Kornbluth, MD; Rakesh Gupta, MD; and Charles D. Gerson, MD
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Requests for Reprints: Asher Kornbluth, MD, Division of Gastroenterology, Box 1069, The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029.

Current Author Addresses: Drs. Kornbluth, Gupta, and Gerson: The Mount Sinai Medical Center, Division of Gastroenterology, Box 1069, One Gustave L. Levy Place, New York, NY 10029.

Ann Intern Med. 1990;113(6):474-475. doi:10.7326/0003-4819-113-6-474
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This excerpt has been provided in the absence of an abstract.

Misoprostol, a prostaglandin E analog, was recently approved for use in the prevention of nonsteroidal anti-inflammatory drug-induced ulcer disease. Its commonest side effects, diarrhea and abdominal cramping (1), may be attributable to the ability of prostaglandin E to stimulate small-bowel secretion (2) and motility (3). In patients with inflammatory bowel disease, prostaglandin E2 levels are elevated and such elevations may play a role in causing intestinal inflammation and diarrhea (4). We report the case of a patient with unrecognized Crohn ileocolitis who developed a nearly fatal secretory diarrhea after short-term use of misoprostol.

Case Report: A 56-year-old woman was admitted


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