Purpose: to study the incidence of NSAIDs-induced colonopathy in inpatient and outpatient medical institutions in Saint-Petersburg, to analyze their clinical manifestations, special features of their prevention and treatment. Materials and methods. In 112 patients within the age limit of 44-83 years characteristics of occurrence and symptoms of NSAIDs-induced colonopathy were studied in 12 Saint-Petersburg inpatient and outpatient medical institutions. Most of the patients were observed by rheumatologists, orthopedists, neurologists and cardiologists. 77.6 % were given non-selective NSAIDs, the rest - selective. Besides standardized blood analysis the patients underwent fibrogastroduodenoscopy, fibrocolonoscopy, jejunoscopy, in 3 cases - total capsule endoscopy, in 67 cases mucosa biopsy followed by its histologic analysis Results and Discussion. NSAID colonopathy occurred in 12 % of 933 patients. Their gastrointestinal lesions were associated with NSAIDs. 51.7 % patients with NSAIDs colonopathy had different gastrointestinal disorders - nausea, vomiting, heartburn, constipation, pains in the epigastrium or mesogastrium, acute and chronic diarrhea. Intestinal bleeding was in 7.2 % of patients, in 4 of them there were no prodromal subjective manifestations and bleeding occurred spontaneously. Intestinal perforation was in 2.7 % of patients with NSAIDs colonopathy. Basing on literary data and own experience 7 risk factors of NSAIDs colonopathy were formed. The most important were advanced age, organic intestinal pathology in the anamnesis and simultaneous intake of NSAIDs and glucocorticoids. Data showing inadequate consideration of risk factors by clinicians and algorithms of prevention and early diagnosis of NSAIDs colonopathy are presented, which significantly influence the incidence of this pathology. Data concerning modern ideas of dietary and pharmacological approaches to NSAIDs colonopathy prevention and treatment are described.