The healing of NSAID-induced gastric lesion may be followed by small intestinal and cardiovascular side effects.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among some of the most commonly used medications. Serious adverse effects induced by NSAIDs may occur not only in the upper gastrointestinal tract, but in the small intestine and cardiovascular system. However, these side effects are studied and investigated separately. Here we tested the hypothesis that the healing of indomethacin-induced gastric erosion may be followed by small intestinal and cardiovascular adverse effects. First we examined the development of gastrointestinal lesions 4-24-48-72 h after a single indomethacin (35 mg/kg s.c.) injection given to fasted male rats (refeeding after 4 h). Then with a telemetric device heart rate, core body temperature and locomotion changes were recorded in the freely moving animals for 72 h after indomethacin or its vehicle injection (control). Indomethacin produced hemorrhagic erosion in the glandular stomach 4 h after its administration which was almost completely healed 48 h later. Parallel to the healing a gradual increase of injury to the small intestine became apparent. The control rats' heart rate, core body temperature and locomotion all agreed with a normal circadian rhythm. However, the circadian cycle of rats treated with indomethacin in 24 h after its administration was disrupted: their heart rate rose to it's maximal level and their locomotion and core temperature values fell to their minimal. These results suggest that the healing of gastric erosion induced by a single indomethacin injection may be followed by other pathological events outside of the stomach, among which there may be intestinal injury and a loss of a normal circadian cycle of heart rate as well as body temperature and locomotion.