Journal of Gastroenterology

, Volume 48, Issue 6, pp 689–697

NSAID enteropathy: could probiotics prevent it?

  • Massimo Montalto
  • Antonella Gallo
  • Antonio Gasbarrini
  • Raffaele Landolfi
Review

DOI: 10.1007/s00535-012-0648-2

Cite this article as:
Montalto, M., Gallo, A., Gasbarrini, A. et al. J Gastroenterol (2013) 48: 689. doi:10.1007/s00535-012-0648-2

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs in the world; nevertheless, about 50–70 % of patients on long-term NSAIDs develop small intestine injury, namely NSAID enteropathy, sometimes with serious outcomes. No medications with proven efficacy are yet available to prevent NSAID enteropathy. A series of therapeutic strategies targeting the different mechanisms involved in small bowel injury have been investigated, but without definitive results. Intestinal bacteria and their degradation products are essential for the development of NSAID-induced small bowel lesions, because “germ-free” animals were found to be resistant to indomethacin injuries. Therefore, it has been suggested that modulating the intestinal flora, for example by using probiotics, could protect against NSAID enteropathy. In this work, we reviewed the main therapeutic strategies for NSAID enteropathy, in particular analyzing the available studies relating to the eventual protective role of probiotics. We found that results are not all concordant; nevertheless, the more recent studies provide better understanding about pathogenetic mechanisms involved in small intestinal injury and the role of probiotics, and show encouraging results. Larger and well-designed studies should be performed to evaluate the actual role of probiotics in NSAID enteropathy, the eventual differences among probiotic strains, dose-responses, and optimal duration of therapy.

Keywords

NSAID enteropathy Probiotics Microbiota 

Copyright information

© Springer 2012

Authors and Affiliations

  • Massimo Montalto
    • 1
  • Antonella Gallo
    • 1
  • Antonio Gasbarrini
    • 1
  • Raffaele Landolfi
    • 1
  1. 1.Istituto di Medicina Interna, Policlinico “A. Gemelli”Università Cattolica del Sacro CuoreRomeItaly

Personalised recommendations