Theme |
The newest approach to the small intestinal diseases |
Title |
Small intestinal mucosal injury induced by non-steroidal anti-inflammatory drugs : Evaluation with capsule endoscopy and treatment |
Author |
Shunji Fujimori |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
Author |
Yoko Takahashi |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
Author |
Akihito Ehara |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
Author |
Tsuyoshi Kobayashi |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
Author |
Tsuguhiko Seo |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
Author |
Keigo Mitsui |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
Author |
Shu Tanaka |
Department of Internal Medicine, Division of Gastroenterologyl, Nippon Medical School |
Author |
Atsushi Tatsuguchi |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
Author |
Choitsu Sakamoto |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
[ Summary ] |
Epidemiological studies suggest that NSAIDs may increase the risk of adverse lower gastrointestinal events. Capsule endoscopy and double balloon endoscopy, are advance modalities that now allow for full investigation of the entire small intestine. These examinations have revealed that NSAIDs including aspirin can cause a variety of abnormalities in the small intestine ; such as ulcerations, erosions, denuded areas, bleeding and diaphragm-like strictures. Capsule endoscopy studies have shown that even coadministration of proton pump inhibitors failed to prevent NSAID-induced small intestinal damage in up to 60% of healthy volunteers. At the same time, studies have shown that co-administration of misoprostol or rebamipide partially prevented NSAID-induced small intestinal damage. Further extensive studies are necessary to ascertain the benefi cial effects of misoprostol, rebamipide, and other drugs. |