| 抄録 |
Use of low-dose aspirin（LDA）is well known to be associated with an increased risk of serious upper gastrointestinal complications, such as peptic ulceration and bleeding. Until recently, attention has mainly been focused on aspirin-induced damage of the stomach and duodenum；whether LDA might also be injurious to the small bowel had remained controversial. A recent advance in diagnostic endoscopy, capsule endoscopy（CE）, enables direct visualization of the small bowel injury and has shed light on the small bowel injury induced by aspirin. We assessed the incidence of small bowel injury in healthy volunteers administered with short-term LDA. Subjects were randomly assigned to receive LDA for 14 days（Aspirin group）or no drugs for 14 days（Control group）. After 2 weeks of administration, the incidence of small bowel erosions in the Aspirin group was higher than that in the Control group although the difference was not significant（30% vs. 0%；P=0.210）. Among the healthy subjects, the short-term administration of LDA was associated with a mild mucosal inflammation of the small bowel. In addition, we reviewed the characteristics of small bowel injury with chronic LDA users. This enteropathy was characterized by multiple petechiae, loss of villi, erosions, and ulcers with round, irregular, and punched-out shapes. Some patients had circumferential ulcers with stricture. Furthermore, we evaluated the differences in the small bowel injury between buffered and enteric-coated aspirin. Significant differences in the number of erosions and ulcers were observed between the buffered and enteric-coated aspirin groups（P=0.017 and P=0.037, respectively）. The results suggested that enteric-coated aspirin might be more injurious to the small bowel mucosa than buffered aspirin. |
