# When Relief Backfires: A Case Report of Non-steroidal Anti-inflammatory Drug (NSAID)-Induced Acute Colitis

## TL;DR

A young man's long-term use of over-the-counter NSAIDs led to acute colitis, highlighting potential gastrointestinal risks of these common drugs.

## Contribution

This case report highlights NSAID-induced acute colitis in a young patient without prior medical history.

## Key findings

- An 18-year-old male developed acute colitis after prolonged NSAID use for headaches.
- Colonoscopy and biopsy confirmed colonic crypt infiltrates consistent with NSAID-induced colitis.
- The patient was lost to follow-up after diagnosis and discharge.

## Abstract

The use of non-steroidal anti-inflammatory drugs (NSAIDs) can be traced back to the Greco-Roman era, when willow tree bark extract was commonly used for its analgesic properties. Since their inception, NSAIDs have become a common component of treatment plans, with widespread use across various pathological conditions. However, there has been a recent increase in the incidence and prevalence of both upper and lower gastropathies. This case report examines an 18-year-old Caucasian male with no significant past medical history who presented with new-onset hematochezia and generalized fatigue. He reported daily over-the-counter NSAID use for more than two years prior to the onset of symptoms, primarily to self-treat debilitating daily headaches. Further evaluation with esophagogastroduodenoscopy (EGD) and colonoscopy with biopsy revealed colonic crypt infiltrates. He was diagnosed with acute colitis, discharged from our service, and advised to undergo a repeat colonoscopy in six weeks; however, the patient was ultimately lost to follow-up.