Non steroidal anti-inflammatory drugs (NSAIDs) are used for the relief of pain and several inflammatory disorders, but their
benefits are often offset by morbidity and mortality related to adverse gastrointestinal side effects. Until recently, the focus has been mainly
on NSAID-induced upper gastrointestinal damage to assess the need for treatment and prevention using anti-acid secretory drugs such
as proton pump inhibitors. However, these drugs are not effective for NSAID-induced small intestinal injuries. Therefore, recent
studies have evaluated mucosal protective drugs typically used for gastroduodenal ulcers. Irsogladine maleate (IM) is clinically used as an
anti-ulcer drug in Japan, Korea and China to prevent gastric mucosal damage and also protects the small intestinal mucosa against
NSAID-induced damage in rats, suppressing inflammatory responses . However, in humans, its protective effect in the small intestine has
not been evaluated. Several modalities have been used to evaluate NSAID- induced small intestinal injuries. Capsule endoscopy (CE) revealed that
NSAIDs cause small-bowel injury in as many as50ââ¬â80% of NSAID users. There are several reports of medical therapy for patients
with NSAID-induced small intestinal injuries, but the effect of various mucosal protective drugs has not been established yet. Fecal
calprotectin (FC) has been proposed as a non-invasive marker of intestinal inflammation such as NSAID enteropathy because a
simple assay may establish the diagnosis. However, there are few studies of NSAID-induced small intestinal injury using both FC and CE.
Last date updated on September, 2024