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Multicenter Study
. 2015 Nov 23;9(6):727-33.
doi: 10.5009/gnl14134.

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

Ki-Nam Shim  1 , Eun Mi Song  1 , Yoon Tae Jeen  2 , Jin-Oh Kim  3 , Seong Ran Jeon  3 , Dong Kyung Chang  4 , Hyun Joo Song  5 , Yun Jeong Lim  6 , Jin Soo Kim  7 , Byong Duk Ye  8 , Cheol Hee Park  9 , Seong Woo Jeon  10 , Jae Hee Cheon  11 , Kwang Jae Lee  12 , Ji Hyun Kim  13 , Byung Ik Jang  14 , Jeong Seop Moon  15 , Hoon Jae Chun  16 , Myung-Gyu Choi  7 ; Korean Gut Image Study Group
Affiliations
Multicenter Study

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

Ki-Nam Shim et al. Gut Liver. .

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.

Keywords: Anti-inflammatory agents, non-steroidal; Capsule endoscopy; Outcome.

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Figures

Fig. 1
Fig. 1
Flow chart of the study subjects. NSAID, nonsteroidal anti-inflammatory drug.
Fig. 2
Fig. 2
Type of medication (A) and the period of nonsteroidal anti-inflammatory drug (NSAID) prescription (B). Data are presented as number (%).
Fig. 3
Fig. 3
Capsule endoscopic findings of nonsteroidal anti-inflammatory drug-induced small intestinal injury. Erosions (A), ulcerations (B), and strictures (C) were noted.
Fig. 4
Fig. 4
Treatment modalities of patients with nonsteroidal anti-inflammatory drug (NSAID)-induced small intestinal injury. Data are presented as number (%).
See this image and copyright information in PMC

Comment in

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