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A 75-year-old woman presented with severe abdominal pain and diarrhoea. Symptoms started 10 years earlier but multiple investigations failed to offer a clear diagnosis. On recent admission, blood tests, endoscopies and CT scans indicated chronic colonic inflammation.

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Nicorandil-induced colonic ulceration.

BMJ Case Rep

February 2015

Department of General Surgery, Stockport NHS Foundation Trust, Stockport, UK.

A 76-year-old woman with significant cardiovascular comorbidities was investigated under general surgery for weight loss and change in bowel habit. Endoscopic investigations revealed a large ulcer extending from the ileocaecal valve to the ascending colon. Histology of the biopsies from this site revealed chronic inflammation and reactive changes.

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Nicorandil associated colonic ulceration: case series of an increasingly recognized complication.

Dig Dis Sci

August 2011

Department of Gastroenterology, Downe Hospital, South Eastern Health and Social Care Trust, 2 Struell Wells Road, Downpatrick, BT30 6RL, Northern Ireland, UK.

Background: Nicorandil is widely accepted in the therapeutic armamentarium of ischemic heart disease and, although nicorandil-induced oral and anal ulcerations have been established in the literature, only five cases have reported the possibility of nicorandil-induced ulceration elsewhere in the gastrointestinal tract. There have been recent case reports which have suggested the possible causative association between nicorandil and colonic ulceration, either in isolation or in combination with anal ulceration.

Methods: We report a case series of eight patients prescribed with nicorandil therapy presenting with gastrointestinal symptoms and subsequently diagnosed with colonic ulceration on colonoscopy.

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