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    Clinical manifestations and endoscopic features of non-steroidal anti-inflammatory drugs-induced small intestinal mucosa damage

    Zhou Jinqiu;Liang Jin;Zhang Qiao;Gan Huatian;Department of Geriatrics Medicine,West China Hospital,Sichuan University;  
    Objective To explore the clinical manifestations and endoscopic features of patients with non-steroidal anti-inflammatory drugs(NSAIDs)-induced small intestinal mucosa damage and to provide evidence for their diagnosis and treatment.Methods A total of 171 patients who came to our hospital due to obscure gastrointestinal bleeding from January 2013 to December 2017 and had a history of NSAIDs administration were enrolled.NSAIDs-induced small intestinal mucosa damage were eventually diagnosed in 110 patients.Their clinical data were collected, and group comparison and retrospective analysis were conducted.Results The rate of small intestinal mucosa damage in NSAIDs patients was 64.3%,and digestive tract hemorrhage[100.0%,including melena(65.9%)and bloody stool(34.1%)]was the most common manifestation.Patients with the age≥60 years old and those who took the drug continuously for longer than 3 months were more likely to have small intestinal mucosa damage(P0.05).Erosive lesions(71.8%)was the most common feature of endoscopy.The occurrence rates of erosive lesions and submucosal hemorrhage were higher than those in the jejunum,whlie the occurrence rate of ulcers was lower than that in the ileum(P0.05).Patients taking non-aspirin NSAIDs were more likely to have ulcers than those taking low-dose aspirin(P0.05).Conclusion NSAIDs-induced intestinal damage is more common in the elderly and people who have been on sustained medication for a long time.However,the diagnosis should be combined with medical history and endoscopy etc,because of atypical clinical manifestations.In addition,it should be aware of ileal ulcers in people with long-term use of non-aspirin NSAIDs.
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