GI Medical Literature

concerning Stevens-Johnson Syndrome

Zweiban, 1986 Gastrointestinal involvement complicating Stevens-Johnson syndrome

Powell, 2006 Colonic involvement in Stevens-Johnson syndrome

British Medical Journal, 2005  British Study Finds Increased Risk Of GI Problems For COX-2 Inhibitors And NSAIDs

Byron Cryer, M.D., Gastrointestinal Effects of NSAIDs and COX-2 Specific Inhibitors

The syndrome may be an allergic reaction to certain drugs, or it may follow pregnancy, herpes virus I, or other infection. It is rarely seen linked with cancer or with radiation therapy. Early diagnosis with the early recognition and withdrawal of all potential causative drugs is most important for a successful treatment. A dermatologist is the needed to establish the diagnosis. Some severe cases of Stevens Johnson Syndrome may require the involvement of a burn specialist or plastic surgery specialist. Depending on which organ is affected, consultations with a gastroenterologist, pulmologist, ophthalmologist, and nephrologist and other specialist may be helpful.

There is there is no effective treatment to stop the spread of Stevens Johnson Syndrome throughout the body. Primary treatment is supportive and symptomatic. Treatment includes management of Stevens Johnson Syndrome symptoms. Treatment includes bed rest, antibiotics for pneumonia, painkilling drugs, mouthwashes, and sedatives. Usually Stevens Johnson Syndrome has been caused by an allergic reaction to a drug or an infection. Also is important to find out which drug caused this disorder. Stop usage of the offending drug or treating the infection can have a positive influence on the progress of Stevens Johnson Syndrome. Drugs such as Bextra and antibiotics should be discontinued immediately.

Underlying infection should be recognized. Underlying diseases or infections which is causing Stevens Johnson Syndrome must be treated. Antibiotics are appropriate if superinfection is cause of Stevens Johnson Syndrome. Antibiotics also are used if bacterial disease, such as mycoplasma, is suspected to be the cause. When respiratory tract is affected (lung) treatment include: aerosols, bronchial aspiration and physical therapy. Some drugs are needed like heparin which is recommended for the duration of hospitalization. In some cases antacids reduce the incidence of gastric bleeding. Emotional and psychiatric support can be helpful.

Treatment whit corticosteroids are controversial. Some scientists think that corticosteroids provoke increased risk of infection, prolonged wound healing, masking of early signs of sepsis, severe gastrointestinal bleeding and increased mortality.

If someone has Stevens Johnson Syndrome, during disease usually suffers from massive fluid loss. So, treatment includes fluid replacement and electrolyte correction. Disease spreading can cause compromise of the cardiovascular and respiratory systems. So, one of the most important part of treatment is to ensure blood flow and blood pressure and airway stability. Pain management is also important part of treatment, because this disease is a very painful disorder. Intensive supportive care is important in severe cases. The patient must be transferred to an intensive care unit or a burn center. Skin lesions should be treated as burns. Denudated skin must be covered with compresses of saline or Burow solution. Careful daily control is necessary to monitor for secondary superinfections. Some specific treatment options can be applied to reduce the symptoms like mouthwash treatment for lesions in the mouth, and topical anesthesia to reduce pain. Saline compresses may be applied to the eyelids, lips, and nose.