Key result
Low-dose aspirin was associated with significantly lower mean capsule endoscopy scores (154 vs 520) and fewer erosions/ulcers compared to non-aspirin NSAIDs.
Why the study?
Does low-dose aspirin cause less severe small-bowel mucosal injury compared to non-aspirin NSAIDs in patients with obscure gastrointestinal bleeding?
Cohort (n=118)
Does low-dose aspirin cause less severe small-bowel mucosal injury compared to non-aspirin NSAIDs in patients with obscure gastrointestinal bleeding?
Absolute Event Rate: 154% vs 520%
Low-dose aspirin is associated with significantly milder small-bowel mucosal injuries, characterized by fewer erosions and ulcers, compared to non-aspirin NSAIDs.
May favor low-dose aspirin to limit small-bowel injury in obscure GI bleeding; hypothesis-generating and requires prospective confirmation.
BACKGROUND/AIMS: The differences in the severity of small-bowel toxicity induced by aspirin and non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) remain unclear. This study aimed at clarifying these differences in small-bowel mucosal injury by using capsule endoscopy (CE). METHODS: We retrospectively compared the records of 78 and 40 obscure gastrointestinal bleeding patients receiving low-dose aspirin (LDA) and non-aspirin NSAIDs, respectively. All patients were found to have small-bowel mucosal injuries on CE. The two groups were compared for the number of small-bowel mucosal injuries and CE scores on the basis of the findings of CE. RESULTS: The mean numbers of reddened lesions in the LDA group and non-aspirin NSAID group were 2.49 ± 3.15 and 1.65 ± 3.04; the mean numbers of erosions/ulcers 1.56 ± 3.75 and 6.08 ± 10.4, and the mean CE scores 154 ± 294 and 520 ± 758, respectively. The mean number of reddened lesions was significantly higher and the mean number of erosions/ulcers and CE scores significantly lower in the LDA group than in the other non-aspirin NSAID group. CONCLUSION: Small-bowel mucosal injuries were significantly milder in the LDA group than in the non-aspirin NSAID group, though reddened lesions were more frequent in the LDA group.
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Watari et al. (2014) conducted a cohort in Obscure gastrointestinal bleeding with small-bowel mucosal injuries (n=118). Low-dose aspirin vs. Non-aspirin NSAIDs was evaluated on Capsule endoscopy (CE) scores. Low-dose aspirin was associated with significantly lower mean capsule endoscopy scores (154 vs 520) and fewer erosions/ulcers compared to non-aspirin NSAIDs.
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