Thiazides With Potassium Producing Intestinal Stenosis

BEFORE 1963, reports of nonspecific ulcers of the small bowel were uncommon, with approximately 170 cases in the world literature.¹ In September, 1964, Lindholmer and associates³ reported four cases of stenosis and ulceration of the jejunum in a two-month period and retrospectively analyzed 16 additional cases since 1957. They first suggested the possibility that the increasing use of enteric-coated thiazides with potassium were etiologically related to the increasing frequency of small-bowel ulcers. In November 1964, Baker and colleagues² reported 12 cases of small-bowel ulceration occuring over an 18-month period, an unusually high incidence in their hospital. Eleven of these patients had been treated with hydrochlorothiazide and potassium (Esidrix or Hydro-Diuril) in enteric-coated form for eight days to 33 months, and represented a small but significant portion of the 470 patients who had received this medication. At the same time 330 patients had received hydrochlorothiazide with potassium, not