| Theme |
Intestinal Mucosal Damage Induced by Drugs |
| Title |
Drug Induced Enteropathy |
| 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 |
Tsuguhiko Seo |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
| Author |
Yukie Yamada |
Department of Internal Medicine, Division of Gastroenterology, 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 ] |
Capsule endoscopy and double balloon endoscopy, advanced modalities that now allow for full investigation of the entire small intestine, have revealed that NSAIDs can cause a variety of abnormalities in the small intestine；such as ulcerations, perforation, bleeding and diaphragm-like stricture. Capsule endoscopy studies have shown that as little as a two week administration of conventional NSAIDs induce small intestinal damage in up to 60％ of healthy volunteers. Moreover, enteric coated low-dose aspirin also induces small intestinal damage in up to 50％ of healthy volunteers. In relation to the prevention of NSAID-induced small intestinal injury, several studies have already shown that celecoxib, a selective COX-2 inhibitor, effectively reduces mucosal breaks induced by 2 week treatment with NSAIDs. Recently, in Japan, misoprostol and rebamipide have been investigated for the prevention of NSAID-induced small intestinal injury. Confirmation of conditions with capsule endoscopy along with administration of misoprostol and rebamipide may prevent NSAID-induced macroscopic damage throughout the small intestine. |