INTESTINE Vol.13 No.5(4-3-2)

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
Publish Date 2009/09
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.
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