title: Risk factors for severe nonsteroidal anti-inflammatory drug-induced small intestinal damage.
abstract: BACKGROUND
  Few studies have assessed the risk factors associated with nonsteroidal anti-inflammatory drugs (NSAIDs)-induced small intestinal damage.
  
  
  OBJECTIVE
  To evaluate the risk factors for NSAID-induced enteropathy in patients with rheumatoid arthritis.
  
  
  METHODS
  A cross-sectional study using capsule endoscopy was conducted. A total of 113 patients who took NSAIDs for over 3 months underwent capsule endoscopies. Endoscopic findings were scored as (0) normal, (1) red spots, (2) 1-4 erosions, (3) >4 erosions, or (4) large erosions/ulcers. Initial scores were grouped into 3 categories: No damage (0-1), mild damage (2), and severe damage (3-4), and the potential risk factors for damage development were assessed.
  
  
  RESULTS
  Five patients were excluded because of incomplete visualization of the entire small intestine. Fifty-two (47.2%) and 27 (25%) patients had no damage and mild damage, respectively, while the remaining 30 patients (27.8%) had severe damage and significantly decreased hemoglobin levels. In a multivariate logistic regression analysis, ages of 65 years or more (odds ratio [OR], 4.16; 95% confidence interval [CI], 1.51-11.47), proton pump inhibitor usage (OR, 5.22; 95% CI, 1.36-20.11), and histamine H2 receptor antagonist usage (OR, 3.95; 95% CI, 1.28-12.25) were independent risk factors for severe damage.
  
  
  CONCLUSIONS
  Elderly patients and acid suppressant users are more likely to develop severe NSAID-induced enteropathy.
authors: Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan. watanabet@med.osaka-cu.ac.jp
authors: Toshio
authors: T
authors: Watanabe
authors: Tetsuya
authors: T
authors: Tanigawa
authors: Yuji
authors: Y
authors: Nadatani
authors: Yasuaki
authors: Y
authors: Nagami
authors: Satoshi
authors: S
authors: Sugimori
authors: Hirotoshi
authors: H
authors: Okazaki
authors: Hirokazu
authors: H
authors: Yamagami
authors: Kenji
authors: K
authors: Watanabe
authors: Kazunari
authors: K
authors: Tominaga
authors: Yasuhiro
authors: Y
authors: Fujiwara
authors: Tatsuya
authors: T
authors: Koike
authors: Tetsuo
authors: T
authors: Arakawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D053705:Capsule Endoscopes; D003430:Cross-Sectional Studies; D020776:Endoscopes, Gastrointestinal; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D007421:Intestine, Small / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal