salicylates and Irritable-Bowel-Syndrome

Traveler's diarrhea (TD) is the most common travel-related illness, and it can have a significant impact on the traveler. Pretravel consultation provides an excellent opportunity for the clinician to counsel the traveler and discuss strategies such as food and water hygiene, vaccinations, and medications for prophylaxis or self-treatment that may decrease the incidence and impact of TD. Postinfectious sequelae, such as postinfectious irritable bowel syndrome, reactive arthritis, and Guillain-Barre syndrome, may develop weeks or months after return.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Antidiarrheals; Arthritis, Reactive; Bismuth; Dehydration; Diarrhea; Female; Fluid Therapy; Foodborne Diseases; Guillain-Barre Syndrome; Humans; Immunocompromised Host; Irritable Bowel Syndrome; Organometallic Compounds; Pregnancy; Probiotics; Risk Factors; Salicylates; Travel; Travel Medicine; Vaccines; Waterborne Diseases

Salicylate intolerance is defined as a nonspecific antigen-induced pseudo-allergic hypersensitivity reaction which can occur upon contact of an organism with salicylic acid, its derivatives or other related organic or inorganic acids of similar chemical structure. Since the effects of nonsteroidal anti-inflammatory drugs (NSAID) intolerance are by no means always severe or life-endangering but may just as well present as oligosymptomatic or local disorders (e.g. abdominal pain, diarrhea, we decided to evaluate the characteristics of patients with salicylate intolerance on the basis of gastroenterological case material of Medical Department I of Erlangen University. On the basis of the findings from the Erlangen interdisciplinary data register of chronic inflammatory gastrointestinal disease, the signs and symptoms of NSAID intolerance were found to constitute a diagnosis of great practical import to clinical medicine (allergology, dermatology, immunology, other disorders etc.) including gastroenterology. For approx. 2-7% of all patients with inflammatory bowel syndrome and food allergies this poses a new diagnostic and therapeutic challenge which may concern physicians from any of the disciplines involved. When presented with patients with chronic active disease who are suffering from these symptoms one should, therefore, in future give greater thought to the possibility of salicylate intolerance, all the more as there are meaningful dietetic, diagnostic and therapeutic options available for these persons.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Colitis, Ulcerative; Crohn Disease; Diet; Drug Hypersensitivity; Food Hypersensitivity; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Lower Gastrointestinal Tract; Malabsorption Syndromes; Mesalamine; Salicylates