Drug-Induced Enterocolitis: Prevention and management in primary care

Drug-induced enterocolitis is an increasing diagnosed condition which includes a variety of morphological and functional alterations of the small and large intestine as a consequence of the exposure to pharmacological active compounds. A number of factors play a major role or participate to the onset of enterocolitis which is the result of an interplay between the effect of the drug molecule and the tolerance of the bowel toward damaging insults. Age, sex, dose of drug, time of exposure, pharmaceutical preparation, drug-drug and drug-food interactions, gut barrier integrity, underlying intestinal conditions, gut microbiota composition are all involved in the appearance and extent of the injury. This article approaches the topic by a primary care's point of view, focusing on epidemiology, mechanisms of damage, protective systems and diagnostic tools. Although first line therapeutic measure is drug discontinuation, some potential options for prevention and treatment are discussed.