Omeprazole increased small intestinal mucosal injury in two of six disease-free cases evaluated by capsule endoscopy

Objective. To investigate gastric and small intestinal mucosal injury in asymptomatic patients taking enteric-coated aspirin using magnetically controlled capsule endoscopy. Methods. Patients taking enteric-coated aspirin (aspirin group) and healthy controls (control group) were recruited from Beijing Anzhen Hospital, Capital Medical University, between September 2017 and May 2018, and undertook magnetically controlled capsule endoscopy. Results. Twenty-six subjects were recruited to the aspirin group and twenty-six to the control group; the median Gastrointestinal Symptom Rating Scale scores were 3.50 and 3.00 (P=0.200), the median gastric Lanza scores were 2.50 and 1.00 (P<0.001), the small intestinal Lanza scores were 1.00 and 0.00 (P<0.001), the gastric controlled examination times were 50.0 and 51.0 min (P=0.171), the small intestinal transit times were 240.0 and 238.0 min (P=0.654), and the capsule excretion times were 24.0 and 24.0 hours (P=0.956), respectively. Conclusions. Rates of gastric and small intestinal mucosal injuries were significantly higher in patients without obvious gastrointestinal symptoms taking enteric-coated aspirin compared to healthy controls. Magnetically controlled capsule endoscopy constitutes a safe, real-time screening modality for gastric and small intestinal mucosal injury in patients taking enteric-coated aspirin.

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Prevalence of Gastric and Small-Intestinal Mucosal Injury in Elderly Patients Taking Enteric-Coated Aspirin by Magnetically Controlled Capsule Endoscopy

Gastroenterology Research and Practice ◽

10.1155/2019/1582590 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Feng Gao ◽

Xue Chen ◽

Jie Zhang

Keyword(s):

Elderly Patients ◽

Capsule Endoscopy ◽

The Elderly ◽

Mucosal Injury ◽

Middle Aged ◽

Enteric Coated Aspirin ◽

History Of ◽

Intestinal Mucosal Injury ◽

Small Intestinal ◽

Enteric Coated

Objective. To investigate aspirin-related gastric and small-intestinal mucosal injury in elderly patients by magnetically controlled capsule endoscopy (MCCE). Methods. Patients taking enteric-coated aspirin attending the outpatient department of Beijing Anzhen Hospital, Capital Medical University, from September 2017 to July 2019 underwent MCCE to assess injury to the gastric and small-intestinal mucosa. The patients were divided into the elderly group (age≥60 years) and middle-aged group (45 years≤age<60 years), and their clinical data were evaluated. Results. Sixty-eight patients (34 per group) taking enteric-coated aspirin were recruited, and the elderly and middle-aged groups did not differ significantly in sex, history of smoking, history of alcohol consumption, body mass index, or accompanying diseases. In the elderly and middle-aged groups, the gastric Lanza scores were 2.0 (2.0, 3.0) and 2.0 (1.0, 3.0; P=0.192), the numbers of patients with small-intestinal mucosal injuries (at least one erosion and/or ulcer) were 30 (88.2%) and 15 (44.1%; P<0.001), the numbers of patients with more severe small-intestinal mucosal injuries (larger erosion and/or ulcer) were 11 (32.4%) and 3 (8.8%; P=0.033), the numbers of patients with ileal erosion were 22 (64.7%) and 8 (23.5%; P=0.001), and the durations of aspirin use were 30.0 (12.0, 120.0) and 10.5 (2.0–48.0) months (P=0.007), respectively. Conclusions. The rate of small-intestinal mucosal injury was significantly higher in elderly than in middle-aged patients taking enteric-coated aspirin, especially the rate of ileal erosion. MCCE enables the monitoring of aspirin-related gastric and small-intestinal mucosal injury in elderly patients, which can guide treatment decision making.

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Effect of Weikang Capsule (胃康胶囊) on Aspirin-Related Gastric and Small Intestinal Mucosal Injury

Chinese Journal of Integrative Medicine ◽

10.1007/s11655-021-3300-2 ◽

2021 ◽

Author(s):

Lin Du ◽

Feng Gao ◽

Jie Zhang

Keyword(s):

Mucosal Injury ◽

Intestinal Mucosal Injury ◽

Small Intestinal

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Influence of Helicobacter pylori Infection on the Small Intestinal Mucosa

ISRN Endoscopy ◽

10.5402/2013/408931 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5

Author(s):

Mitsunori Maeda ◽

Masakazu Nakano ◽

Hideyuki Hiraishi

Keyword(s):

Helicobacter Pylori ◽

Negative Relationship ◽

Mucosal Injury ◽

Enzyme Linked Immunosorbent Assay ◽

Small Intestinal Mucosa ◽

Significant Negative Relationship ◽

Positive Rate ◽

Intestinal Mucosal Injury ◽

Small Intestinal ◽

H Pylori

Background/Aims. To investigate the role of Helicobacter pylori infection in the development of enteritis (small intestinal mucosal injury). Methodology. Between April 2007 and January 2013, 99 patients undergoing capsule endoscopy (CE) were tested for anti-H. pylori immunoglobulin G antibody (Hp-IgG) using an enzyme-linked immunosorbent assay (ELISA). None of the patients had been treated for H. pylori infection or diagnosed as having Crohn’s disease or any other clinically apparent small intestinal disorders prior to the CE. Results. The overall Hp-IgG-positive rate was 26.3%. The incidence of enteritis, as diagnosed by CE, tended to be lower in the Hp-IgG-positive patients (23.1%) than in the Hp-IgG-negative patients (38.4%) (). When patients receiving aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), well-known causes of enteritis, were excluded, the incidence of enteritis in the Hp-IgG-positive patients (11.7%) was significantly lower than that in the Hp-IgG-negative patients (43.7%) (). A binomial logistic regression analysis revealed a significant negative relationship between Hp-IgG positivity and the presence of enteritis in patients receiving neither aspirin nor NSAIDs (). Conclusions. Our data indicated that H. pylori positivity was inversely associated with the prevalence of enteritis.

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Extent and Duration of Small Intestinal Mucosal Injury in Intractable Diarrhea of Infancy

PEDIATRICS ◽

10.1542/peds.66.5.730 ◽

1980 ◽

Vol 66 (5) ◽

pp. 730-735

Author(s):

Thomas M. Rossi ◽

Emanuel Lebenthal ◽

Kenneth S. Nord ◽

Rafiqua R. Fazili

Keyword(s):

Elemental Diet ◽

Mucosal Injury ◽

Height Velocity ◽

Common Finding ◽

Small Intestinal Mucosa ◽

Intractable Diarrhea ◽

Young Infants ◽

Intestinal Mucosal Injury ◽

Small Intestinal

Thirty infants with intractable diarrhea of infancy (IDI) underwent small bowel biopsies in order to determine the extent and duration of small intestinal mucosal injury. The onset of the persistent diarrhea occurred prior to 3 months of age and continued for an average of 48 days prior to investigation. In 18 cases, no associated entities were found. Mucosal injury was invariably found in all 30 infants: grade IV injury in 11, grade III in eight, grade II in nine, and grade I atrophy in one. Disaccharidase activities were diminished and corresponded to the degree of atrophy. Lactase activity was diminished to a greater extent than sucrase and maltase. Significant, persistent mucosal injury existed for an average of six months in 16 of the 23 (70%) repeat biopsies. All infants were given an elemental diet (ED). Twelve of the 30 infants required parenteral nutrition (PN). These infants were gradually advanced to an oral elemental diet and maintained on this diet until histologic findings and disaccharidase levels were normal. Eighteen infants were fed and maintained on an elemental diet by mouth from time of admission until normal histologic findings and disaccharidases were found. No mortality occurred during management and follow-up. Twenty-two of the 28 infants in whom follow-up growth data were available excelled in weight and height velocity. The data suggest that prolonged injury to the small intestinal mucosa is a common finding in many cases of intractable diarrhea of infancy. Elemental diets should be started early in the course of protracted diarrhea in young infants, and may need to be continued for several months since histologic and enzymatic changes of the small intestine may persist for extended periods.

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