NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study

Background. The purpose of study was to evaluate the diagnostic yield of capsule endoscopy for NSAID-induced enteropathy and clinical, laboratory, and endoscopic characteristics of disease in patients with rheumatoid arthritis. Methods. 37 rheumatoid arthritis patients (30 women; mean age 55) treate...

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Main Authors: Ilja Tachecí, Petr Bradna, Tomáš Douda, Drahomíra Baštecká, Marcela Kopáčová, Stanislav Rejchrt, Jan Bureš
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2013/268382
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author Ilja Tachecí
Petr Bradna
Tomáš Douda
Drahomíra Baštecká
Marcela Kopáčová
Stanislav Rejchrt
Jan Bureš
author_facet Ilja Tachecí
Petr Bradna
Tomáš Douda
Drahomíra Baštecká
Marcela Kopáčová
Stanislav Rejchrt
Jan Bureš
author_sort Ilja Tachecí
collection DOAJ
description Background. The purpose of study was to evaluate the diagnostic yield of capsule endoscopy for NSAID-induced enteropathy and clinical, laboratory, and endoscopic characteristics of disease in patients with rheumatoid arthritis. Methods. 37 rheumatoid arthritis patients (30 women; mean age 55) treated with NSAIDs (>1 month), presented with anaemia and/or positive faecal occult blood testing, entered the study and underwent capsule endoscopy (EndoCapsule; Olympus), laboratory tests, and filled in questionnaires. Results. The prevalence of NSAID-induced enteropathy diagnosed by capsule endoscopy was 68% (25/37), classified as mild (red spots or erosions) in 18 (49%), moderate (10–20 erosions) in 4 (11%), and severe enteropathy (>20 erosions or ulcers) in 3 (8%) patients. We did not find statistically significant relationship between the enteropathy and gender, age, haemoglobin, leukocytes, albumin and CRP, or dyspepsia. The difference between subgroups of NSAIDs according to the COX specificity was not statistically significant. Conclusions. Capsule endoscopy is a highly accurate noninvasive method for evaluation of NSAID-induced enteropathy. It was revealed in a substantial section of the patients with rheumatoid arthritis and occult gastrointestinal bleeding, mostly classified as mild damage. No simple clinical or laboratory markers of the presence or severity of NSAID-induced enteropathy were recognised. This trial is registered with DRKS00004940.
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institution Kabale University
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spelling doaj-art-f01c655b2ffb466981b4628c2b43b0ae2025-02-03T05:50:58ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/268382268382NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy StudyIlja Tachecí0Petr Bradna1Tomáš Douda2Drahomíra Baštecká3Marcela Kopáčová4Stanislav Rejchrt5Jan Bureš6Second Department of Internal Medicine-Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech RepublicSecond Department of Internal Medicine-Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech RepublicSecond Department of Internal Medicine-Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech RepublicSecond Department of Internal Medicine-Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech RepublicSecond Department of Internal Medicine-Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech RepublicSecond Department of Internal Medicine-Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech RepublicSecond Department of Internal Medicine-Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech RepublicBackground. The purpose of study was to evaluate the diagnostic yield of capsule endoscopy for NSAID-induced enteropathy and clinical, laboratory, and endoscopic characteristics of disease in patients with rheumatoid arthritis. Methods. 37 rheumatoid arthritis patients (30 women; mean age 55) treated with NSAIDs (>1 month), presented with anaemia and/or positive faecal occult blood testing, entered the study and underwent capsule endoscopy (EndoCapsule; Olympus), laboratory tests, and filled in questionnaires. Results. The prevalence of NSAID-induced enteropathy diagnosed by capsule endoscopy was 68% (25/37), classified as mild (red spots or erosions) in 18 (49%), moderate (10–20 erosions) in 4 (11%), and severe enteropathy (>20 erosions or ulcers) in 3 (8%) patients. We did not find statistically significant relationship between the enteropathy and gender, age, haemoglobin, leukocytes, albumin and CRP, or dyspepsia. The difference between subgroups of NSAIDs according to the COX specificity was not statistically significant. Conclusions. Capsule endoscopy is a highly accurate noninvasive method for evaluation of NSAID-induced enteropathy. It was revealed in a substantial section of the patients with rheumatoid arthritis and occult gastrointestinal bleeding, mostly classified as mild damage. No simple clinical or laboratory markers of the presence or severity of NSAID-induced enteropathy were recognised. This trial is registered with DRKS00004940.http://dx.doi.org/10.1155/2013/268382
spellingShingle Ilja Tachecí
Petr Bradna
Tomáš Douda
Drahomíra Baštecká
Marcela Kopáčová
Stanislav Rejchrt
Jan Bureš
NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study
Gastroenterology Research and Practice
title NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study
title_full NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study
title_fullStr NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study
title_full_unstemmed NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study
title_short NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study
title_sort nsaid induced enteropathy in rheumatoid arthritis patients with chronic occult gastrointestinal bleeding a prospective capsule endoscopy study
url http://dx.doi.org/10.1155/2013/268382
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