Drugs

, Volume 32, Supplement 1, pp 35–41

Effect of Non-Steroidal Anti-Inflammatory Drugs on the Human Small Intestine

  • I. Bjarnason
  • G. Zanelli
  • P. Prouse
  • P. Williams
  • M. J. Gumpel
  • A. J. Levi
Section 1: Mode of Action

DOI: 10.2165/00003495-198600321-00007

Cite this article as:
Bjarnason, I., Zanelli, G., Prouse, P. et al. Drugs (1986) 32(Suppl 1): 35. doi:10.2165/00003495-198600321-00007

Summary

The suggestion that the intestinal mucosa may be abnormally permeable and thus a site of antigen absorption in rheumatoid arthritis was tested by a 51CrEDTA intestinal permeability test. Twelve patients with rheumatoid arthritis untreated by non-steroidal anti-inflammatory drugs (NSAIDs) had normal test results, while 12 NSAID-treated patients had increased intestinal permeability. Ten volunteers ingested aspirin, ibuprofen and indomethacin 8 and 1 hours before the study. The increased intestinal permeability was proportional to drug potency to inhibit cyclo-oxygenase. Intestinal permeability also increased following an indomethacin suppository, which suggests that the effect is systemically mediated.

111Indium leucocyte scintigrams and faecal collection showed no evidence of intestinal inflammation in 9 patients untreated by NSAIDs. Twenty-nine of 53 NSAID-treated patients showed abnormal localisation of 111indium in the right iliac fossa at 20 hours, and 32 of 49 patients had increased faecal excretion of 111indium. A 99mTc-porphyrin scan suggested that the main site of NSAID-induced intestinal inflammation was the small bowel. NSAIDs are thus shown to disrupt intestinal integrity and long term treatment leads to inflammation of the small intestine.

Copyright information

© ADIS Press Limited 1986

Authors and Affiliations

  • I. Bjarnason
    • 1
    • 2
  • G. Zanelli
    • 1
    • 2
  • P. Prouse
    • 1
    • 2
  • P. Williams
    • 1
    • 2
  • M. J. Gumpel
    • 1
    • 2
  • A. J. Levi
    • 1
    • 2
  1. 1.Section of Gastroenterology and Division of RadioisotopesMRC Clinical Research CentreUK
  2. 2.Division of RheumatologyNorthwick Park HospitalHarrowUK
  3. 3.Section of Gastroenterology, Division of Clinical SciencesMRC Clinical Research CentreHarrowUK