Study: NSAIDs May Cause More Intestinal Damage Than Thought

Non-steroidal anti-inflammatory drugs (NSAIDs) may damage more of the intestine than previously thought, according to a Baylor College of Medicine study presented May 20 at the Digestive Disease Week 2003 conference in Orlando, FL.

More than 100 million prescriptions for NSAIDS are written annually in the United States, many of them for patients with arthritis.

Using images taken by a capsule-sized pill containing a special camera, the researchers detected small bowel erosions in 62 percent of NSAID users compared to 5 percent of non-NSAID users.

According to the researchers, NSAIDs reduce pain and inflammation over time by affecting inflammation-causing chemicals. The same group of chemicals are also in the stomach, leading NSAIDs to cause indigestion, and possibly duodenal or stomach ulceration.

Dr. David Graham, lead author of the study and a professor of medicine and molecular virology at Baylor, said the study shows that patients taking NSAIDs regularly have an increased risk of small intestinal mucosal ulceration and bleeding.

The study involved 40 patients with various forms of arthritis, including osteoarthritis, rheumatoid arthritis and gout. Half of the patients were given NSAIDS daily for three months, while the other half served as a control group and either took acetaminophen alone or nothing at all.

Severe injury to the small bowel was seen in 23 percent of NSAID users compared to no severe injury in the control group. Severe damage was associated with high doses of indomethacin, naproxen, oxyprozocin and ibuprofen, all types of NSAIDs.

"This is a significant finding and suggests the need for periodic diagnostic monitoring with capsule endoscopy of patients who take NSAIDs regularly," Graham said.

Other sources: Baylor College of Medicine