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- Title
Non-steroidal anti-inflammatory drug-induced enteropathy as a major risk factor for small bowel bleeding: a retrospective study.
- Authors
Lim, Doo-Ho; Jung, Kyoungwon; Lee, Seung Bum; Park, In Kyu; Cha, Hee Jeong; Park, Jae Ho; Kim, Byung Gyu; Jung, Seok Won; In Du Jeong; Kim, Jae Hyun; Kim, Sung Eun; Moon, Won; In Park, Moo; Park, Seun Ja
- Abstract
<bold>Background: </bold>Small bowel (SB) bleeding accounts for 5% of all gastrointestinal (GI) bleeding cases and 80% of obscure GI bleeding cases. Although angioectasia is the common etiology of SB bleeding, nonsteroidal anti-inflammatory drug (NSAID)-induced SB lesions are also reported as a major cause in studies from Eastern countries. Herein, we assessed the frequency of occurrence of NSAID-induced SB lesions in Korean patients with obscure GI bleeding.<bold>Methods: </bold>We retrospectively analyzed medical records of all consecutive patients aged ≥18 years who underwent capsule endoscopy from March 2018 to February 2019 at Ulsan University Hospital and Kosin University Gospel Hospital.<bold>Results: </bold>Of the 83 subjects (all Korean; mean age ± standard deviation: 59 ± 18 years; age range: 18-84 years; men: n = 52; women: n = 31), 55 (66.2%) had stool with clear blood and 28 (33.8%) had normal stool with iron deficiency anemia. The detection rate of SB bleeding and lesions using capsule endoscopy was 72.3% (60 of 83 patients). A significantly higher frequency (40 of 51) of ulcerative/erosive lesions than other causes was observed in patients with inactive bleeding but visible SB lesions. As a result, NSAID-induced enteropathy accounted for 30.1% of 83 patients with obscure GI bleeding (25 of the all 60 SB bleeding cases).<bold>Conclusions: </bold>Contrary to what is reported for patients in Western countries, this study in Korean patients showed an improved diagnostic yield of capsule endoscopy for obscure GI bleeding and that NSAID-induced enteropathy was the most common etiology of SB bleeding. Aggressive small intestine examination is required for patients with unexplained GI bleeding.
- Subjects
GASTROINTESTINAL hemorrhage; IRON deficiency anemia; HEMORRHAGE; CAPSULE endoscopy; WESTERN countries; TOOTH erosion
- Publication
BMC Gastroenterology, 2020, Vol 20, Issue 1, p1
- ISSN
1471-230X
- Publication type
journal article
- DOI
10.1186/s12876-020-01329-5