Non-steroidal anti-inflammatory drugs – potential risks and benefits in the gastrointestinal tract distal to the ligament of Treitz
Bibliographic record
Abstract
The toxicity of non-steroidal anti-inflammatory drugs (NSAIDs) related to the upper gastrointestinal (GI) tract is well established.However, they may cause injury distal to the duodenum as well -to the small and large intestine and/or to other organs of the digestive system.Non-steroidal anti-inflammatory drugs induce small intestinal perforation, ulcers or strictures requiring surgery and inflammation with blood and protein loss called NSAID enteropathy.These drugs can exacerbate pre-existing large bowel disease (e.g.ulcerative colitis, diverticular disease) and precipitate relapse of inactive disease or the new onset of inflammatory bowel disease (IBD) with rapid resolution of symptoms on their withdrawal.They have been implicated in the development of microscopic colitis.Non-steroidal antiinflammatory drugs-associated toxicity of the small and large bowel is increasingly recognized in clinical practice, as enteroscopic procedures become more frequently used.Liver injury is an uncommon, but potentially lethal complication.It can occur with all NSAIDs, but diclofenac and sulindac seem to be most commonly associated with the problem.These drugs may contribute to acute fatty liver of pregnancy.Hepatotoxicity is likely due to an idiosyncratic reaction resulting from an immunological response or altered metabolic pathways.The major benefits of NSAIDs relate to reports of possible prevention, delay or regression of progress towards cancer of the colon, oesophagus, stomach as well as of cancer of the breast, lung, prostate and skin.Despite their promise, NSAIDs are not yet recommended for prevention or treatment of any cancer, because the balance of hazards and benefits from the treatment must be resolved in the designated patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.023 | 0.012 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".