ASSOCIATIONS BETWEEN DRUGS AND SMALL-BOWEL MUCOSAL BLEEDING: MULTICENTER CAPSULE-ENDOSCOPY STUDY

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  • NIIKURA Ryota
    Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.
  • YAMADA Atsuo
    Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.
  • MAKI Koutarou
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine.
  • NAKAMURA Masanao
    Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine.
  • WATABE Hirotsugu
    Department of Gastroenterology, Wakamiya Watabe Clinic.
  • FUJISHIRO Mitsuhiro
    Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo. Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital.
  • OKA Shiro
    Department of Endoscopy, Hiroshima University Hospital.
  • ESAKI Motohiro
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.
  • FUJIMORI Shunji
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine.
  • NAKAJIMA Atsushi
    Dvision of Gastroenterology and Hepatology, Yokohama City University School of Medicine.
  • OHMIYA Naoki
    Department of Gastroenterology, Fujita Health University School of Medicine.
  • MATSUMOTO Takayuki
    Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University.
  • TANAKA Shinji
    Department of Endoscopy, Hiroshima University Hospital.
  • KOIKE Kazuhiko
    Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.
  • SAKAMOTO Choitsu
    Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine.

Bibliographic Information

Other Title
  • 薬剤と小腸粘膜障害，小腸出血との関連：多施設カプセル内視鏡研究
  • Associations between drugs and small‐bowel mucosal bleeding: Multicenter capsule‐endoscopy study

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<p>Background and Aim: Although several drugs may induce small-bowel mucosal injuries, it is unclear whether these injuries contribute to overt small-bowel bleeding. This study was designed to evaluate the associations between drug use and small-bowel mucosal injury and between these mucosal injuries and overt bleeding in a disease-relevant population.</p><p>Methods: We retrospectively studied patients with suspected small-bowel diseases who underwent capsule endoscopy between 2010 and 2013. Drug exposure, Charlson Comorbidity Index, smoking, and alcohol consumption were assessed before capsule endoscopy. Adjusted odds ratios (AOR) and confidence intervals (CI) were estimated for small-bowel mucosal injury and small-bowel overt bleeding. </p><p>Results: In total, 850 patients were analyzed during the study period. Median age was 64 years, and 544 patients (64.0%) were men. Among the patients with small-bowel mucosal injury (n = 60) and without mucosal injury (n = 705), use of nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR 1.8, 95% CI 1.01-3.31) was significantly associated with an increased risk of small-bowel mucosal injury compared with non-use. Patients with small-bowel mucosal injury with overt bleeding (n = 85) and without overt bleeding (n = 60) were compared, and no significant difference between the groups in the usage rates for NSAIDs, thienopyridine, other antiplatelets, anticoagulants, acetaminophen, tramadol hydrochloride, or steroids was revealed, even after adjusting for confounders.</p><p>Conclusion: Although the use of NSAIDs was significantly associated with an increased risk of small-bowel mucosal injury, no significant associations were observed between the use of such drugs and small-bowel overt bleeding.</p>

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