Clinical Features and Endoscopic Findings of NSAID-related Mucosal Lesions in the Upper Gastrointestinal Tract Jun-ichi Iwamoto 1 , Yuji Mizokami 1 , Koichi Shimokobe 1 , Masanori Ito 1 , Hisashi Takehara 1 , Tsuyoshi Hirayama 1 , Tadashi Ikegami 1 , Yoshifumi Saito 1 , Yasushi Matsuzaki 1 1Department of Gastroenterology, Tokyo Medical University Kasumigaura Hospital, Ibaraki, Japan Keyword: NSAID , Helicobacter pylori , 上部消化管病変 pp.1701-1711
Published Date 2007/11/25
DOI https://doi.org/10.11477/mf.1403101223
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 It has been demonstrated that Non-steroidal anti-inflammatory drugs (NSAID) have been the most common cause of drug-induced ulceration in the last 20 years. With the advent of our aging society, the number of patients with ischemic heart disease and cerebrovascular disease has increased. This has resulted in the widespread use of Low-dose aspirin (L-Asp). It is suggested that L-Asp induces gastrointestinal mucosal injury. In this study, we classified peptic ulcers diagnosed in our hospital into the low-dose aspirin-induced group (Group A), the non-aspirin-NSAID-induced group (Group N), aspirin and non-aspirin-NSAID free group (Group C). The proportion of Group N and Group A was 25%and 7%. Bleeding events such as hematemesis, melena and anemia occurred in 53.6%, 45.2%and 31.2%in Group A, N and C. The ratio of ulcers located in the antrum were 24%, 32%and 16%in Group A, N and C. The ratio of ulcers located in the antrum was higher in Group A and N than in Group C. There was a tendency for the size of ulcers to be smaller in Group A than in Group N. There was no difference in the number of ulcers in each group. The prevalence of H. pylori was significantly lower in group N than in Group C. There was no diffrence in the prevalence of H. pylori in Group A and C.

 It has been suggested that typical NSAID-induced ulcers have decreased and on the other hand, L-Asp-related ulcers located in the corpus have increased. Prevention of L-Asp-related gastrointestinal mucosal damage is needed.

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