Journal of Gastroenterology

, Volume 44, Supplement 19, pp 57–63

Nonsteroidal anti-inflammatory drug-induced small-bowel lesions identified by double-balloon endoscopy: endoscopic features of the lesions and endoscopic treatments for diaphragm disease

  • Yoshikazu Hayashi
  • Hironori Yamamoto
  • Hiroki Taguchi
  • Keijiro Sunada
  • Tomohiko Miyata
  • Tomonori Yano
  • Masayuki Arashiro
  • Kentaro Sugano
International Forum 1

DOI: 10.1007/s00535-008-2277-3

Cite this article as:
Hayashi, Y., Yamamoto, H., Taguchi, H. et al. J Gastroenterol (2009) 44(Suppl 19): 57. doi:10.1007/s00535-008-2277-3

Abstract

Background

Nonsteroidal anti-inflammatory drugs (NSAIDs) occasionally induce small-bowel injury. However, the clinical features have only been partially clarified. The aim of this study was to clarify the clinical features of the disease and evaluate the effectiveness of endoscopic balloon dilation therapy for diaphragm disease, using double-balloon endoscopy (DBE).

Methods

This is a retrospective case study using our DBE database. Our inclusion criteria required patients to meet all the following criteria: (1) history of NSAID use; (2) endoscopic findings of erosion and/or ulcer and/or typical diaphragm-like strictures; (3) improvement in clinical findings (signs and symptoms) and/or endoscopic findings by cessation of NSAIDs, except for diaphragm disease; and (4) exclusion of other causes (e.g., malignant tumor, inflammatory bowel disease, and infectious disease). The clinical records of patients were investigated.

Results

Eighteen patients were included. Sixteen patients showed ulcerative lesions, and the remaining 2 patients showed diaphragm diseases. For localized lesions, 12 patients evidenced lesions in the ileum, 5 patients had lesions in the duodenum and/or jejunum, and 1 had lesions in both intestines. The ulcerative lesions were multiple with various morphologies that were located unrelated to mesenteric or antimesenteric sides. The endoscopic balloon dilations were performed safely, and all patients improved with regard to their symptoms.

Conclusions

Symptomatic NSAID-induced small-bowel injuries exhibit a variety of patterns of ulcerative lesions as observed in the ileum in many cases. The endoscopic balloon dilation appears to be a safe and effective treatment for diaphragm disease.

Key words

NSAIDs double-balloon endoscopy small-bowel injury diaphragm disease endoscopic balloon dilation 

Copyright information

© Springer Japan 2009

Authors and Affiliations

  • Yoshikazu Hayashi
    • 1
  • Hironori Yamamoto
    • 1
  • Hiroki Taguchi
    • 1
  • Keijiro Sunada
    • 1
  • Tomohiko Miyata
    • 1
  • Tomonori Yano
    • 1
  • Masayuki Arashiro
    • 1
  • Kentaro Sugano
    • 1
  1. 1.Department of Medicine, Division of GastroenterologyJichi Medical UniversityShimotsukeJapan

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