Interní Med. 2006; 8(11): 489-492

NSAID’s gastropathy and enteropathy

prof. MUDr. Milan Lukáš CSc

IV. interní klinika VFN a 1. LF UK, Praha

NSAID gastropathy is defined by the stomach and (or) duodenal mucosal injuries due to nonsteroidal anti-inflammatory drugs therapy regardless of the clinical symptomatology is present. Currently, the NSAID therapy is leading cause of peptic ulcer complications with high mortality rate which is around 10 %. The most of patients with NSAID gastropathy are without clinical symptomatology and severe complications particularly bleeding or perforation are the first manifestations. The active approach due to selection of the high risk groups of patients is needed, because there is a chance how to minimalize high frequency of NSAID gastropathy. The extremely high risk of patients for NSAID gastropathy should be treated by coxibs and proton pump inhibitors (PPI). In patients with moderate risk for NSAID gastropathy nonselective NSAIDs with prophylactic PPI treatment are recommended. NSAID enteropathy is a relatively new clinical entity, which is characterized by focal or diffuse injuries of the small or large bowel mucosa (erosions or ulcers) due to NSAIDs therapy. Clinical manifestations of NSAID enteropathy are very polymorphic, the sideropenic anemia accurs the most frequently. The introduction of capsule endoscopy into the clinical practice led to precise assessment of nonselective NSAIDs and coxibs on intestinal mucosa. There was proved, that coxib‘s toxicity on the intestinal mucosa is significantly lower. In contrast to upper GIT, the prophylactic therapy with proton pump inhibitors are quite ineffective for a NSAID enteropathy development.

Keywords: Key words: NSAID gastropathy, NSAID enteropathy, peptic ulcer, antisecretory treatment.

Published: March 1, 2007  Show citation