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

K. Shim,E. Song,Y. Jeen,Jin-Oh Kim,Seong Ran Jeon,D. Chang,H. Song,Y. Lim,J. S. Kim,B. Ye,C. Park,Seong Woo Jeon,J. Cheon,Kwang-Jae Lee,Ji Hyun Kim,B. Jang,J. Moon,H. Chun,Myung-Gyu Choi

Published 2014 in Gut and 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.

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