| Theme |
Appropriate Application of New Guidelines for GI Endoscopy in Patients with Antithrombotics |
| Title |
Antithrombotics-induced Gastrointestinal Damage : Pathogenesis, Management, and Prevention -- Gastroduodenal Damage |
| Author |
Toshio Watanabe |
Department of Gastroenterology, Osaka City University Graduate School of Medicine |
| Author |
Tetsuya Tanigawa |
Department of Gastroenterology, Osaka City University Graduate School of Medicine |
| Author |
Yuji Nadatani |
Department of Gastroenterology, Osaka City University Graduate School of Medicine |
| Author |
Kazunari Tominaga |
Department of Gastroenterology, Osaka City University Graduate School of Medicine |
| Author |
Yasuhiro Fujiwara |
Department of Gastroenterology, Osaka City University Graduate School of Medicine |
| Author |
Tetsuo Arakawa |
Department of Gastroenterology, Osaka City University Graduate School of Medicine |
| [ Summary ] |
Antithrombotic agents, especially low-dose aspirin (LDA), frequently induce mucosal injuries such as erosions or ulcers in the upper gastrointestinal tract. Gastrointestinal bleeding is the most important complication related to LDA-induced injuries. Aspirin is thought to cause gastric damage through two pathways : aspirin irreversibly inhibits cyclooxygenase activity, resulting in a deficiency of mucosal prostaglandins. It also injures the mucosa by acting as a topical irritant. Recent clinical studies have revealed that PPIs are most effective in prevention and treatment of LDA-induced mucosal injuries. In 2012, the Japan Gastroenterological Endoscopy Society developed a new guideline for the management of antithrombotic therapy for gastrointestinal endoscopic procedures. This guideline permitted the use ofinvasive endoscopy without cessation of antithrombotics. Since many statements in this guideline are not based on high-quality evidence, the guideline should be verified through prospective studies. |