Small Bowel Ulceration in Patients Receiving Non-Steroidal Anti-inflammatory Drugs for Rheumatoid Arthritis

Evidence is presented for a non-specific ulcerative process in the small bowel of patients with rheumatoid arthritis. All three cases presented with lower gastrointestinal bleeding; on withdrawal of non-steroidal anti-inflammatory drugs no further bleeding occurred. Non-steroidal anti-inflammatory drugs may lead to small bowel ulceration in inhibiting mucosal glycoprotein synthesis and increasing intestinal permeability.