Gut Liver.  2015 Nov;9(6):727-733. 10.5009/gnl14134.

Long-Term Outcomes of NSAID-Induced Small Intestinal Injury Assessed by Capsule Endoscopy in Korea: A Nationwide Multicenter Retrospective Study

Affiliations
  • 1Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. ytjeen@korea.ac.kr
  • 3Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea.
  • 6Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea.
  • 7Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 8Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea.
  • 9Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
  • 10Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
  • 11Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 12Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
  • 13Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
  • 14Department of Gastroenterology, Inje University College of Medicine, Busan, Korea.
  • 15Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
We evaluated the long-term outcome and clinical course of patients of nonsteroidal anti-inflammatory drug (NSAID)-induced small intestinal injury by performing capsule endoscopy (CE).
METHODS
A multicenter retrospective study was conducted using data collected from the CE nationwide database registry, which has been established since 2002.
RESULTS
A total of 140 patients (87 males; mean age, 60.6+/-14.8 years) from the CE nationwide database registry (n=2,885) were diagnosed with NSAID-induced small intestinal injury and enrolled in our study. Forty-nine patients (35.0%) presented with a history of aspirin use and an additional 49 (35.0%) were taking NSAIDs without aspirin. The most prominent findings after performing CE were multiple ulcerations (n=82, 58.6%) and erosions or aphthae (n=32, 22.9%). During the follow-up period (mean, 15.9+/-19.0 months; range, 0 to 106 months), NSAID-induced small intestinal injury only recurred in six patients (4.3%). Older age and hypertension were positive predictive factors for recurrence.
CONCLUSIONS
These results suggest that the recurrence of NSAID-induced small bowel injury was not frequent in the presence of conservative treatment. Therefore, the initial diagnosis using CE and the medication history are important.

Keyword

Anti-inflammatory agents; non-steroidal; Capsule endoscopy; Outcome

MeSH Terms

Age Factors
Aged
Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
Aspirin/adverse effects
*Capsule Endoscopy
Female
Humans
Intestinal Diseases/chemically induced/*pathology
Intestine, Small/*drug effects/injuries/*pathology
Male
Middle Aged
Recurrence
Republic of Korea
Retrospective Studies
Time Factors
Ulcer/chemically induced/*pathology
Anti-Inflammatory Agents, Non-Steroidal
Aspirin
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