title: Small intestinal injury in NSAID users suffering from rheumatoid arthritis or osteoarthritis.
abstract: The goal of this prospective study was to assess non-steroidal anti-inflammatory drug (NSAID)-induced enteropathy in patients with rheumatoid arthritis (RA) or osteoarthritis (OA) by means of non-invasive wireless capsule enteroscopy. A total of 143 patients (74 with RA, 69 with OA) treated with NSAIDs (>1 month) and 42 healthy volunteers were included. All subjects underwent capsule endoscopy, laboratory tests and filled in questionnaires. The severity of small bowel injury was graded as: mild (red spots or sporadic erosions), moderate (10-20 erosions) or severe (>20 erosions or ulcers). Capsule endoscopy identified small bowel lesions in 44.8 % of patients (mild 36.4 %, moderate 3.5 % and severe in 4.9 %). Mild non-specific lesions were found in 11.9 % healthy volunteers. There was a significantly higher prevalence of enteropathy in RA (56.8 %) compared to OA (31.9 %, p < 0.01). A significant difference between NSAID users (RA and OA) with and without enteropathy was observed in erythrocytes (p < 0.01), the leucocyte count (p < 0.05), haemoglobin (p < 0.05), haematocrit (p < 0.05), serum albumin (p < 0.01) and erythrocyte sedimentation rate (p < 0.05). No relationship was found between enteropathy and dyspepsia, gender or age. NSAID therapy is associated with a significant risk of small bowel injury. The risk is significantly higher in RA patients suggesting a possible influence of the underlying disease.
  
  
  BACKGROUND
  DRKS00004940.
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic. tacheci@gmail.com.
authors.forename: Ilja
authors.identifier: http://orcid.org/0000-0003-3583-2651
authors.initials: I
authors.lastname: Tachecí
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Bradna
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Douda
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Drahomíra
authors.initials: D
authors.lastname: Baštecká
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Marcela
authors.initials: M
authors.lastname: Kopáčová
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Stanislav
authors.initials: S
authors.lastname: Rejchrt
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Lutonský
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Soukup
authors.affiliation: Second Department of Internal Medicine - Gastroenterology, Faculty of Medicine at Hradec Králové, University Hospital, Charles University in Prague, Sokolská 581, 50003, Hradec Králové, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bureš
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D053704:Capsule Endoscopy; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D015995:Prevalence; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Enteropathy; Non-steroidal anti-inflammatory drug; Osteoarthritis; Rheumatoid arthritis; Small bowel; Wireless capsule endoscopy