Risk factors for small-bowel mucosal breaks in chronic low-dose aspirin users: data from a prospective multicenter capsule endoscopy registry.
BACKGROUND
To develop appropriate management strategies for patients who take low-dose aspirin, it is important to identify the risk factors for GI injury. However, few studies have described the risk factors for small-bowel injury in these patients.


OBJECTIVE
To investigate factors influencing the risk of small-bowel mucosal breaks in individuals taking continuous low-dose aspirin.


METHODS
Capsule endoscopy data were collected prospectively from 5 institutions.


METHODS
Yokohama City University Hospital and 4 other hospitals.


METHODS
A total of 205 patients receiving treatment with low-dose aspirin for over 3 months.


METHODS
Colonoscopic and upper GI endoscopy had been performed in all of the patients before the capsule endoscope evaluation.


METHODS
Risk factors for small-bowel mucosal breaks.


RESULTS
Of the 198 patients (141 male; mean age 71.9 years) included in the final analysis, 114 (57.6%) had at least 1 mucosal break. Multivariate analysis identified protein pump inhibitor (PPI) use (OR 2.04; 95% confidence interval [CI], 1.05-3.97) and use of enteric-coated aspirin (OR 4.05; 95% CI, 1.49-11.0) as independent risk factors for the presence of mucosal breaks.


CONCLUSIONS
Cross-sectional study.


CONCLUSIONS
PPI use appears to increase the risk of small-bowel injury in patients who take continuous low-dose aspirin. Clinicians should be aware of this effect of PPIs; new strategies are needed to treat aspirin-induced gastroenteropathy.
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Hiroki
H
Endo
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Eiji
E
Sakai
Department of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki, Japan.
Leo
L
Taniguchi
Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan.
Takaomi
T
Kessoku
Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan.
Yasuhiko
Y
Komiya
Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan.
Akiko
A
Ezuka
Department of Gastroenterology, Odawara Municipal Hospital, Odawara, Japan.
Harunobu
H
Kawamura
Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Masataka
M
Taguri
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Takuma
T
Higurashi
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Hidenori
H
Ohkubo
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Eiji
E
Yamada
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Hirokazu
H
Takahashi
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Masahiko
M
Inamori
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Shin
S
Maeda
Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan.
Takashi
T
Sakaguchi
Department of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki, Japan.
Yasuo
Y
Hata
Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan.
Hajime
H
Nagase
Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Atsushi
A
Nakajima
D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D053704:Capsule Endoscopy; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010437:Peptic Ulcer / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012042:Registries; D013608:Tablets, Enteric-Coated
D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D013608:Tablets, Enteric-Coated; D001241:Aspirin