title: Prevention of traditional NSAID-induced small intestinal injury: recent preliminary studies using capsule endoscopy.
abstract: Capsule endoscopy and balloon endoscopy, advanced modalities that now allow for full investigation of the entire small intestine, have revealed that non-steroidal anti-inflammatory drugs (NSAIDs) can cause a variety of abnormalities in the small intestine. Traditional NSAIDs can induce small intestinal injuries in over 50% of patients. Several studies have shown that the preventive effect of proton pump inhibitors does not extend to the small intestine, suggesting that concomitant therapy may be required to prevent small intestinal side effects associated with traditional NSAIDs use. Recently, several randomized controlled trials used capsule endoscopy to evaluate the preventive effect of certain drugs on NSAID-induced small intestinal injuries. These studies show that misoprostol and rebamipide have a preventive effect for NSAID-induced small intestinal mucosal injuries. However, these studies included only a small series of healthy volunteers and tested short-term NSAID treatment. Therefore, further extensive studies are clearly required to ascertain the beneficial effect of these drugs.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo 113-8603, Japan. s-fujimori@nms.ac.jp
authors.forename: Shunji
authors.initials: S
authors.lastname: Fujimori
authors.forename: Yoko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Tsuguhiko
authors.initials: T
authors.lastname: Seo
authors.forename: Katya
authors.initials: K
authors.lastname: Gudis
authors.forename: Akihito
authors.initials: A
authors.lastname: Ehara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Keigo
authors.initials: K
authors.lastname: Mitsui
authors.forename: Masaoki
authors.initials: M
authors.lastname: Yonezawa
authors.forename: Shu
authors.initials: S
authors.lastname: Tanaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tatsuguchi
authors.forename: Choitsu
authors.initials: C
authors.lastname: Sakamoto
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D053704:Capsule Endoscopy; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D006801:Humans; D007410:Intestinal Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D007421:Intestine, Small / Q000293:injuries*; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D054328:Proton Pump Inhibitors