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Randomized Controlled Trial
. 2011 Dec 14;17(46):5117-22.
doi: 10.3748/wjg.v17.i46.5117.

Aspirin-induced small bowel injuries and the preventive effect of rebamipide

Kazuhiro Mizukami  1 , Kazunari Murakami, Takashi Abe, Kunimitsu Inoue, Masahiro Uchida, Tadayoshi Okimoto, Masaaki Kodama, Toshio Fujioka
Affiliations
Randomized Controlled Trial

Aspirin-induced small bowel injuries and the preventive effect of rebamipide

Kazuhiro Mizukami et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the influence of taking low-dose aspirin for 4 wk on small intestinal complications and to examine the preventive effect of rebamipide.

Methods: This study was conducted as a single-center, randomized, double-blind, cross-over, placebo-controlled study. Eleven healthy male subjects were enrolled. Each subject underwent video capsule endoscopy after 1 and 4 wk of taking aspirin and omeprazole, along with either rebamipide or placebo therapy. The primary endpoint was to evaluate small bowel damage in healthy subjects before and after taking low-dose aspirin for 4 wk.

Results: The number of subjects with mucosal breaks (defined as multiple erosions and/or ulcers) were 1 at 1 wk and 1 at 4 wk on the jejunum, and 6 at 1 wk (P = 0.0061) and 7 at 4 wk on the ileum (P = 0.0019). Rebamipide significantly prevented mucosal breaks on the ileum compared with the placebo group (P = 0.0173 at 1 wk and P = 0.0266 at 4 wk).

Conclusion: Longer-term, low-dose aspirin administration induced damage in the small bowel. Rebamipide prevented this damage, and may be a candidate drug for treating aspirin-induced small bowel complications.

Keywords: Capsule endoscopy; Healthy subjects; Low-dose aspirin; Rebamipide; Small bowel injury.

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Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Typical small intestinal red spot, erosion and ulcer. A: Typical red spot; B: Typical erosion; C: Typical ulcer.
Figure 3
Figure 3
Low-dose aspirin-related small bowel injuries in the placebo group. The open circle indicates the number of low-dose aspirin-related small bowel injuries in the jejunum, and the closed circle indicates the number of injuries in the ileum at 4 wk. The data are represented as the mean ± SD. aP < 0.05, bP < 0.01.
Figure 4
Figure 4
Case with a large ulcer of the small intestine induced by low-dose aspirin. A large ulcer was observed in the small intestine as a result of 4 wk of low-dose aspirin ingestion. The ulcer occupied one-third of the interior of the small intestine.
See this image and copyright information in PMC

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