| 抄録 |
Background：To develop appropriate management strategies for patients who take low-dose aspirin, it is important to identify risk factors for gastrointestinal injury. However, few studies have described risk factors for small bowel injury in these patients. To investigate factors that affect risk for breaks in the small bowel mucosa among individuals who take continuous low-dose aspirin.
Methods：We analyzed data from 205 consecutive low-dose aspirin users who underwent capsule endoscopy for the investigation of small bowel disease at 5 hospitals in Japan. Any identified small bowel mucosal breaks were classified into small erosions or large erosions/ulcers. Risk factors for small bowel mucosal breaks were assessed using logistic regression analysis.
Results：Of the 198 patients（141 males；mean age 71.9 years）included in the final analysis, 114（57.6%）had at least 1 mucosal break. Multivariate analysis identified PPI use（OR, 2.04；95% CI, 1.05-3.97）and use of enteric-coated aspirin（OR, 4.05；95% CI, 1.49-11.0）as independent risk factors for the presence of mucosal breaks. In addition, PPI use was also indentified as an independent risk factor for the development of large erosions/ulcers（OR, 3.42；95% CI, 1.55-6.76）.
Conclusions：PPI use appears to increase the risk for small bowel injury among patients who take continuous low-dose aspirin. Consistent with our results, the possibility that acid suppression may exacerbate NSAID/aspirin-induced small bowel injuries has been suggested by recent studies（Wallace et al. Gastroenterology 2011）. Clinicians should be aware of these effects of PPIs；new strategies are needed to treat aspirin-induced gastroenteropathy.
Keywords：small bowel injury, low-dose aspirin, capsule endoscopy |
