| Long-term effects of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 selective agents on the small bowel: a cross-sectional capsule enteroscopy study. | |
| | |
MedLine Citation:
|
PMID: 17625980 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND & AIMS: Nonsteroidal anti-inflammatory drug (NSAID) gastropathy is sufficiently important as to warrant co-administration of misoprostol or proton pump inhibitors or a switch to selective cyclooxygenase (COX)-2 inhibitors. However, the serious ulcer outcome studies suggested that 40% of the clinically significant gastrointestinal bleeding originated more distally, presumably from NSAID enteropathy. We used capsule enteroscopy to study small-bowel damage in patients on long-term NSAIDs and COX-2-selective agents. METHODS: Sixty healthy volunteers acted as controls. One hundred twenty and 40 patients on long-term NSAIDs and COX-2 selective agents, respectively, underwent a capsule enteroscopy study. Small-bowel damage was categorized and quantitated. RESULTS: Sixty-two percent of patients on conventional NSAIDs were abnormal, which differed significantly (P < .001) from controls. The main pathology related to reddened folds (13%), denuded areas (39%), and mucosal breaks (29%). Two percent had diaphragm-like strictures and 3% had bleeding without an identifiable lesion. The damage, seen in 50% of patients on selective COX-2 inhibitors (reddened folds, 8%; denuded areas, 18%; and mucosal breaks, 22%), did not differ significantly (P > .5) from that seen with NSAIDs. CONCLUSIONS: Long-term NSAIDs and COX-2-selective agents cause comparable small-bowel damage. This suggests an important role for COX-2 in the maintenance of small-bowel integrity. The results have implications for strategies that aim to minimize the gastrointestinal damage in patients requiring anti-inflammatory analgesics. |
| | |
Authors:
|
Laurence Maiden; Bjarni Thjodleifsson; Anna Seigal; Ingvar Iain Bjarnason; David Scott; Sigurbjorn Birgisson; Ingvar Bjarnason |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2007-07-10 |
Journal Detail:
|
Title: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Volume: 5 ISSN: 1542-7714 ISO Abbreviation: Clin. Gastroenterol. Hepatol. Publication Date: 2007 Sep |
Date Detail:
|
Created Date: 2007-09-10 Completed Date: 2007-11-01 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101160775 Medline TA: Clin Gastroenterol Hepatol Country: United States |
Other Details:
|
Languages: eng Pagination: 1040-5 Citation Subset: IM |
Affiliation:
|
Department of Medicine, King's College Hospital, London, United Kingdom. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Administration, Oral Adolescent Adult Aged Aged, 80 and over Anti-Inflammatory Agents, Non-Steroidal / administration & dosage, adverse effects* Capsule Endoscopy / methods* Confidence Intervals Cross-Sectional Studies Cyclooxygenase 2 Inhibitors / administration & dosage, adverse effects England / epidemiology Female Follow-Up Studies Humans Iceland / epidemiology Intestinal Diseases / chemically induced, pathology* Intestinal Mucosa / drug effects, pathology Intestine, Small / drug effects*, pathology Male Middle Aged Prognosis Risk Factors Time Factors |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Cyclooxygenase 2 Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Work and resources needed for endoscopic resection of large sessile colorectal polyps.
Next Document: Use of health care resources and cost of care for adults with constipation.