The Pathogenesis and Consequence of Non Steroidal Anti-Inflammatory Drug Induced Small Intestinal Inflammation in Man

Bjarnason, Ingvar; Zanelli, G. D.; Smith, T.; Smethurst, Paul; Price, Allison; Gumpel, M.; Levi, A J

doi:10.3109/03009748709096722

Cited by 65 publications

(40 citation statements)

References 22 publications

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“…Different studies have shown that after NSAID ingestion the simultaneous intravenous injection of 111 In-labeled leukocytes and 99m Tc-labeled erythrocytes revealed the identical location of both radioactive blood cell types in the intestine, thus suggesting a correlation between the inflammatory and hemorrhagic damage induced in the intestine by these agents [25, 27, 28]. Furthermore, approximately half of the patients with occult GI bleeding while on regular NSAIDs have jejunal or ileal ulcerations [29].…”

Section: Lesions Induced By Nsaids In the Distal Gi Tractmentioning

confidence: 99%

Microbial Flora in NSAID-Induced Intestinal Damage: A Role for Antibiotics?

Lanas

Scarpignato

2006

Digestion

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Upper gastrointestinal (GI) complications are well-recognized adverse events associated with non-steroidal anti-inflammatory drug (NSAID) use. However, NSAID-induced damage to the distal GI tract is also common and more frequent than previously recognized. These untoward effects include increased mucosal permeability, mucosal inflammation, anemia and occult blood loss, malabsorption, protein loss, ileal dysfunction, diarrhea, mucosal ulceration, strictures due to diaphragm disease as well as active bleeding and perforation. Studies with selective COX-2 inhibitors have shown that, in the short term, these agents do not increase mucosal permeability and display a reduced by 50% incidence of serious lower GI side effects compared to traditional NSAIDs. However, the long-term use of this therapeutic strategy is limited by the increased risk of serious cardiovascular events, especially in patients with multiple risk factors. Several studies have suggested that intraluminal bacteria play a significant role in the pathogenesis of small-bowel damage induced by NSAIDs and that enterobacterial translocation into the mucosa represents the first step that sets in motion a series of events leading to gross lesion formation. Experimental and clinical investigations indicate that in the short term, antibacterial agents either reduce or abolish NSAID enteropathy. However, potential adverse effects of systemic antimicrobials and the possible occurrence of drug resistance have so far precluded this interesting approach. The availability of poorly absorbed and effective antibiotics, like rifaximin, may represent an attractive alternative to prevent or limit NSAID-associated intestinal damage.

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Section: Lesions Induced By Nsaids In the Distal Gi Tractmentioning

confidence: 99%

Microbial Flora in NSAID-Induced Intestinal Damage: A Role for Antibiotics?

Lanas

Scarpignato

2006

Digestion

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“…4,7,8 Pinpointing the exact prevalence is precluded by the vague symptoms of this disorder, which impede diagnosis. Bjarnason 7 used nonspecific radionuclide scanning to identify a 66% prevalence in patients who had been taking NSAIDs for longer than 6 months, whereas Allison et al 4 reported a 13.5% ulceration rate in autopsy specimens from patients who had been taking NSAIDs for longer than 6 months.…”

Section: Commentmentioning

confidence: 99%

“…10 Because of the low yield of standard radiologic and endoscopic methods, surgical intervention has often been necessary to make the definitive diagnosis of DD. 7,11,13 The advent of capsule enteroscopy and virtual enterography may facilitate preoperative evaluation of the small bowel.…”

Section: Commentmentioning

confidence: 99%

Small-Bowel Diaphragm Disease

Kelly

McMahon

Jaroszewski³

et al. 2005

Arch Surg

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Small-bowel diaphragm disease is an important source of gastrointestinal tract bleeding and subacute intestinal obstruction that may require surgical intervention.Design: Case series.Setting: Tertiary-care academic medical center.Patients: Seven consecutive patients with histologically confirmed enteropathy induced by use of nonsteroidal anti-inflammatory drugs received treatment at our institution from February 2001 to February 2004.Interventions: Laparotomy with small-bowel resection.Main Outcome Measures: Initial symptoms and signs, findings at diagnostic workup, type of medication and duration of use, operation performed, and intraoperative findings were evaluated.Results: Patients were identified who had symptoms of

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“…Закономерное следствие такого воспаления -развитие анемии, гипо-и диспротеине-мии, что, естественно, усугубляет тяжесть основного заболе-вания, по поводу которого были назначены НПВП [19][20][21]. Известно, что у части пациентов с ревматическими заболе-ваниями имеется гипоальбуминемия, связанная с энтераль-ными белковыми потерями, но не зависящая от приема НПВП.…”

Section: рис 2 возможный патогенез нпвп-индуцированной энтеропатииunclassified

Anti-inflammatory drug-induced injury to the intestinal tube: clinical value, pathogenesis, possibilities of prevention

Евсеев¹

2013

Neurology, Neuropsychiatry, Psychosomatics

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The Pathogenesis and Consequence of Non Steroidal Anti-Inflammatory Drug Induced Small Intestinal Inflammation in Man

Cited by 65 publications

References 22 publications

Microbial Flora in NSAID-Induced Intestinal Damage: A Role for Antibiotics?

Microbial Flora in NSAID-Induced Intestinal Damage: A Role for Antibiotics?

Small-Bowel Diaphragm Disease

Anti-inflammatory drug-induced injury to the intestinal tube: clinical value, pathogenesis, possibilities of prevention

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