| Theme |
Drug-induced gastrointestinal disorders |
| Title |
NSAID-induced small intestinal lesions |
| 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 |
Keigo Mitsui |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
| Author |
Masaoki Yonezawa |
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School |
| Author |
Shu Tanaka |
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 balloon endoscopy are advanced modalities which allow for full investigation of the entire small intestine. They have revealed that nonsteroidal anti-inflammatory drugs (NSAIDs) can cause a variety of abnormalities in the small intestine. Confirmation of small intestinal injury healing after discontinuation of NSAID treatment is necessary to make a diagnosis of NSAIDs-induced small intestinal injury because endoscopic diagnosis of NSAID-induced small intestinal injury is difficult. Recently, several studies have shown that NSAIDs can induce small intestinal injuries with a high degree of prevalence in patients who take these drugs. These reports have shown that the preventive effects of proton pump inhibitors (PPIs) do not extend to the small intestine, suggesting that concomitant therapy may be required to prevent small intestinal side effects associated with NSAID use. Recently, several randomized controlled trials have implemented capsule endoscopy to evaluate the preventive effects of mucoprotective drugs to prevent NSAID-induced small intestinal injury. However, those studies were limited to a small number of subjects and tested short-term NSAID treatment. Therefore, further extensive studies are clearly required to ascertain the beneficial effects of these drugs. |