Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2005; 11(31): 4861-4864
Published online Aug 21, 2005. doi: 10.3748/wjg.v11.i31.4861
Non-steroidal anti-inflammatory drug-induced small bowel injuries identified by double-balloon endoscopy
Yoshikazu Hayashi, Hironori Yamamoto, Hiroto Kita, Keijiro Sunada, Hiroyuki Sato, Tomonori Yano, Michiko Iwamoto, Yutaka Sekine, Tomohiko Miyata, Akiko Kuno, Takaaki Iwaki, Yoshiyuki Kawamura, Hironari Ajibe, Kenichi Ido, Kentaro Sugano
Yoshikazu Hayashi, Hironori Yamamoto, Hiroto Kita, Keijiro Sunada, Hiroyuki Sato, Tomonori Yano, Michiko Iwamoto, Yutaka Sekine, Tomohiko Miyata, Akiko Kuno, Takaaki Iwaki, Yoshiyuki Kawamura, Hironari Ajibe, Kenichi Ido, Kentaro Sugano, Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi, Tochigi 329-0498, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hironori Yamamoto, MD, Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School, Yakushiji, Minamikawachi, Tochigi 329-0498, Japan. yamamoto@jichi.ac.jp
Telephone: +81-285-58-7348 Fax: +81-285-44-8297
Received: December 14, 2004
Revised: January 1, 2005
Accepted: January 5, 2005
Published online: August 21, 2005
Abstract

AIM: To clarify clinical features of the NSAID-induced small bowel lesions using a new method of endoscopy.

METHODS: This is a retrospective study and we analyzed seven patients with small bowel lesions while taking NSAIDs among 61 patients who had undergone double-balloon endoscopy because of gastro-intestinal bleeding or anemia between September 2000 and March 2004, at Jichi Medical School Hospital in Japan. Neither conventional EGD nor colonoscopy revealed any lesions of potential bleeding sources including ulcerations. Double-balloon endoscopy was carried out from oral approach in three patients, from anal approach in three patients, and from both approaches in one patient.

RESULTS: Ulcers or erosions were observed in the ileum in six patients and in the jejunum in one patient, respectively. The ulcers were multiple in all the patients with different features from tiny punched out ulcers to deep ulcerations with oozing hemorrhage or scar. All the patients recovered uneventfully and had full resolution of symptoms after suspension of the drug.

CONCLUSION: NSAIDs can induce injuries in the small bowel even in patients without any lesions in both the stomach and colon.

Keywords: Double-balloon endoscopy; NSAIDS-induced small bowel injuries