title: Risk factors for small bowel bleeding in chronic nonsteroidal anti-inflammatory drug users.
abstract: OBJECTIVE
  The incidence of nonsteroidal anti-inflammatory drugs (NSAIDs)-induced enteropathy is currently increasing. However, the predictors of small bowel bleeding (SBB) associated with NSAIDs are unknown. This study aimed to assess the risk factors of SBB in chronic NSAIDs users.
  
  
  METHODS
  We retrospectively compared the medical records of 147 patients receiving NSAIDs in a tertiary-care setting (31 with SBB and 116 without previous bleeding events) and analyzed the predictors of SBB.
  
  
  RESULTS
  In total, 31 patients underwent video capsule endoscopy to detect SBB, 74.2% of whom showed the evidence of SBB. Non-invasive treatment was performed in 90.3% of the patients. Multivariate logistic regression analysis revealed that the presence of coronary artery disease [adjusted odds ratio (aOR) 12.43, 95% confidence interval (CI) 1.19-130.34, P = 0.04], use of thienopyridine (aOR 16.93, 95% CI 3.78-75.72, P < 0.001) and prior use of rebamipide (aOR 0.31, 95% CI 0.12-0.82, P = 0.02) were independently associated with SBB in NSAIDs users.
  
  
  CONCLUSIONS
  Coronary artery disease and co-use of thienopyridine were associated with SBB in NSAIDs users. The patients with coronary artery disease co-using thienopyridine need to be monitored for the occurrence of SBB when they were prescribed with NSAIDs.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Kyu-Man
authors.initials: KM
authors.lastname: Cho
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Seon-Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Jin Ook
authors.initials: JO
authors.lastname: Chung
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Chung-Hwan
authors.initials: CH
authors.lastname: Jun
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Tae-Jong
authors.initials: TJ
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Dong-Jun
authors.initials: DJ
authors.lastname: Son
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Ban-Suk
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Park
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Sung-Kyu
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Rew
mesh_terms: D000368:Aged; D000409:Alanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D053704:Capsule Endoscopy; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D015363:Quinolones / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D010975:Platelet Aggregation Inhibitors; D011725:Pyridines; D015363:Quinolones; C446540:thienopyridine; C052785:rebamipide; D000409:Alanine
keywords: anti-inflammatory agents; antiplatelet agents; bleeding; coronary artery disease; non-steroidal; small intestine