Non-steroidal anti-inflammatory drug-induced small bowel injuries identified by double-balloon endoscopy.
OBJECTIVE
To clarify clinical features of the NSAID-induced small bowel lesions using a new method of endoscopy.


METHODS
This is a retrospective study and we analyzed seven patients with small bowel lesions while taking NSAIDs among 61 patients who had undergone double-balloon endoscopy because of gastro-intestinal bleeding or anemia between September 2000 and March 2004, at Jichi Medical School Hospital in Japan. Neither conventional EGD nor colonoscopy revealed any lesions of potential bleeding sources including ulcerations. Double-balloon endoscopy was carried out from oral approach in three patients, from anal approach in three patients, and from both approaches in one patient.


RESULTS
Ulcers or erosions were observed in the ileum in six patients and in the jejunum in one patient, respectively. The ulcers were multiple in all the patients with different features from tiny punched out ulcers to deep ulcerations with oozing hemorrhage or scar. All the patients recovered uneventfully and had full resolution of symptoms after suspension of the drug.


CONCLUSIONS
NSAIDs can induce injuries in the small bowel even in patients without any lesions in both the stomach and colon.
Hayashi
Yoshikazu
Y
Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School, Yakushiji, Minamikawachi, Tochigi 329-0498, Japan.
Yamamoto
Hironori
H
Kita
Hiroto
H
Sunada
Keijiro
K
Sato
Hiroyuki
H
Yano
Tomonori
T
Iwamoto
Michiko
M
Sekine
Yutaka
Y
Miyata
Tomohiko
T
Kuno
Akiko
A
Iwaki
Takaaki
T
Kawamura
Yoshiyuki
Y
Ajibe
Hironari
H
Ido
Kenichi
K
Sugano
Kentaro
K
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D002404:Catheterization; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000187:drug effects / Q000293:injuries / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced*; D012189:Retrospective Studies
D000894:Anti-Inflammatory Agents, Non-Steroidal