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Is non-steroidal anti-inflammaory drug (NSAID) enteropathy clinically more important than NSAID gastropathy?

Department of Medicine, Guy’s, King’s, St Thomas’ Medical School, London, UK

Correspondence to:
Correspondence to:
Professor I Bjarnason
Department of Medicine, Guy’s, King’s, St Thomas’ Medical School, Bessemer Road, London SE5 9PJ, UK; ingvar.bjarnason{at}kcl.ac.uk

The side effects of conventional non-steroidal anti-inflammatory drugs (NSAIDs) on the stomach is undoubtedly a serious public health problem contributing significantly to the morbidity and mortality of patients receiving these drugs. However, the damage of NSAIDs is not confined to the stomach. Indeed the short term and long term damage of NSAIDs on the small bowel (NSAID enteropathy) is more frequent than NSAID gastropathy. Furthermore, NSAID enteropathy is associated with complications (bleeding and protein loss). While many of these are mild, the serious events (significant bleeding, perforation, obstruction, and sudden death) are frequent as that reported for NSAID gastropathy. The diagnosis of NSAID enteropathy has been greatly aided by the introduction of wireless capsule enteroscopy.

Keywords: NSAIDs; intestinal damage; toxicity; inflammation

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