Visible small-intestinal mucosal injury in chronic NSAID users

Graham, David Y.; Opekun, Antone R.; Willingham, Field F.; Qureshi, Waqar

doi:10.1016/s1542-3565(04)00603-2

Cited by 506 publications

(396 citation statements)

References 29 publications

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“…Histologically, they are characterized by sub-mucosal fibrosis with normal overlying epithelium, apart from the tip of diaphragm, which may be ulcerated; the mucosa between diaphragms is normal [14,45] . Capsule endoscopy, double-balloon enteroscopy and colonoscopy may help in the diagnosis of NSAIDinduced injury, although there is nothing endoscopically specific about NSAID-induced gut lesions [46,47] . Histology is also nonspecific; the differential diagnosis should include: Campylobacter, Yersinia, Cytomegalovirus, TB infections, IBD, ischemia, radiation enteritis, vasculitides and other drugs.…”

Section: Nsaids Related Intestinal Iniurymentioning

confidence: 99%

Gastrointestinal lesions associated with spondyloarthropathies

Orlando

Renna²,

Perricone³

et al. 2009

WJG

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Subclinical gut inflammation has been described in up to two-thirds of patients with spondyloarthropathies (S pA). Ar t hr i t is represents an extra-intestinal manifestation of several gastrointestinal diseases, including inflammatory bowel disease (IBD), Whipple's disease, Behcet's disease, celiac disease, intestinal bypass surgery, parasitic infections of the gut and pseudomembranous colitis. Moreover about twothirds of nonsteroidal anti-inflammatory drug users demonstrate intestinal inflammation. Arthritis may manifest as a peripheral or axial arthritis. The spondyloarthropathy family consists of the following entities: ankylosing spondylitis, undifferentiated s p o n d y l o a r t h r i t i s , r e a c t i ve a r t h r i t i s , p s o r i a t i c arthritis, spondyloarthritis associated with IBD, juvenile onset spondyloarthritis. This topic reviews the major gastrointestinal manifestations that can occur in patients with SpA and in nonsteroidal antiinflammatory drugs users.

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Section: Nsaids Related Intestinal Iniurymentioning

confidence: 99%

Gastrointestinal lesions associated with spondyloarthropathies

Orlando

Renna²,

Perricone³

et al. 2009

WJG

View full text Add to dashboard Cite

show abstract

“…The most common mimicker of CD in the small bowel is non-steroidal anti-inflammatory medication (NSAID)-induced enteropathy that may manifest with lesions indistinguishable from those of CD. Such lesions, appearing as early as 2 wk from the onset of NSAID therapy, can be demonstrated in 70% of chronic NSAID users [6,7] . Thus, VCE should be reserved for patients with high clinical index of suspicion for CD.…”

Section: Diagnosis Of CDmentioning

confidence: 99%

Role of capsule endoscopy in inflammatory bowel disease

Leighton

Legnani

Seidman

2007

Inflammatory Bowel Diseases

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Videocapsule endoscopy (VCE) has revolutionized our ability to visualize the small bowel mucosa. This modality is a valuable tool for the diagnosis of obscure small bowel Crohn's disease (CD), and can also be used for monitoring of disease activity in patients with established small-bowel CD, detection of complications such as obscure bleeding and neoplasms, evaluation of response to anti-inflammatory treatment and postoperative recurrence following small bowel resection. VCE could also be an important tool in the management of patients with unclassified inflammatory bowel disease, potentially resulting in reclassification of these patients as having CD. Reports on postoperative monitoring and evaluation of patients with ileal pouch-anal anastomosis who have developed pouchitis have recenty been published. Monitoring of colonic inflammatory activity in patients with ulcerative colitis using the recently developed colonic capsule has also been reported. Capsule endoscopy is associated with an excellent safety profile. Although retention risk is increased in patients with small bowel CD, this risk can be significanty decreased by a routine utilization of a dissolvable patency capsule preceding the ingestion of the diagnostic capsule. This paper contains an overview of the current and future WJG 20 th Anniversary Special Issues (3): Inflammatory bowel disease TOPIC HIGHLIGHTclinical applications of capsule endoscopy in inflammatory bowel disease.

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“…Drug induced enteropathy, for instance related to NSAID use, is seen as mucosal erythema, erosions, small ulcers and web like strictures, can be readily diagnosed and monitored by VCE (53).…”

Section: Drug Effectsmentioning

confidence: 99%

Capsule enteroscopy and radiology of the small intestine

Fork

Aabakken

2007

Eur Radiol

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Capsule Enteroscopy and Radiology of the Small Intestine 2 ABSTRACT In a very few years, the video capsule for small bowel enteroscopy has gained widespread clinical acceptance. It is readily ingested, disposable, and allows for a complete, low-invasive endoscopic examination of the entire mucosa of the small bowel. It is a patient-friendly method and a first line procedure in the difficult evaluation of obscure gastrointestinal bleeding. It has the highest proven figure of diagnostic sensitivity for detecting lesions of the mucosa, irrespective of aetiology. The limitations of capsule endoscopy include difficulty in localizing mucosal lesions anatomically and its restricted use in patients with dysphagia, strictures or motor dysfunction. Strictures, transmural and extra-mural lesions in patients with small bowel Crohn's disease are evaluated by MRI-enterography and CT-enterography.Capsule Enteroscopy and Radiology of the Small Intestine 3 Imaging of the small bowel was, until recently, the responsibility of the radiologist, who, in dedicated centres, offered the patient not just a small-bowel follow-through with single exposures over time, but a dedicated, real time, fluoroscopic examination of a well distended small bowel, displayed in double-contrast and documented on spot films (1). This enteroclysis technique, well accepted by gastroenterologists, significantly improved both the detection of mucosal disease and the mapping of involved bowel segments. However, the duration of the examination, discomfort related to nasojejunal intubation and infusion of large volumes of contrast and distension materials, be it methyl cellulose or air (2), reduced general acceptance and dissemination of this method (3). VCE has evolved to be the first line procedure in many hospitals (7-13), keeping small bowel radiology as method of choice for patients who cannot take the capsule (13). In order to understand the diagnostic algorithm of modern small bowel examination we will discuss the video capsule technique, its indications and contraindications, advantages and disadvantages, types of true and false lesions and comparative studies of VCE and radiological methods of investigation of the small intestine. The video capsuleVCE was primarily developed for examination of small bowel mucosa (14,15). Rapid technical refinement has since resulted in a dedicated capsule for the oesophagus, and recently capsules for the study of both stomach and colon (16).The capsule measures 11 by 27mm and includes a light source and a camera inside a clear, transparent dome, batteries and a radio-transmitter (Figure 1). Whilst ushered forward by peristalsis the capsule transmits images continuously at two frames per second for around eight hours, a total of more than 60.000 images. The image has a 140° field of view, a focus depth of 1-30 mm, and an 8:1 magnification (17). An array of eight external detectors, applied to the abdominal wall, receives the images for storage in a solid state data recorder. Capsule Enteroscopy and Radiology of the Smal...

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Visible small-intestinal mucosal injury in chronic NSAID users

Cited by 506 publications

References 29 publications

Gastrointestinal lesions associated with spondyloarthropathies

Gastrointestinal lesions associated with spondyloarthropathies

Role of capsule endoscopy in inflammatory bowel disease

Capsule enteroscopy and radiology of the small intestine

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