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Gastroenterology Research and Practice
Volume 2013 (2013), Article ID 761060, 7 pages
http://dx.doi.org/10.1155/2013/761060
Review Article

Recent Advances in NSAIDs-Induced Enteropathy Therapeutics: New Options, New Challenges

1Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 814 Siksadong, Ilsandonggu, Goyang 410-773, Republic of Korea
2Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1 Anam-dong 5 ga, Seongbuk-gu, Seoul 136-705, Republic of Korea

Received 4 June 2013; Revised 2 August 2013; Accepted 13 August 2013

Academic Editor: Gerassimos Mantzaris

Copyright © 2013 Yun Jeong Lim and Hoon Jai Chun. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The injurious effects of NSAIDs on the small intestine were not fully appreciated until the widespread use of capsule endoscopy. It is estimated that over two-thirds of regular NSAID users develop injury in the small intestinal injuries and that these injuries are more common than gastroduodenal mucosal injuries. Recently, chronic low-dose aspirin consumption was found to be associated with injury to the lower gut and to be a significant contributing factor in small bowel ulceration, hemorrhage, and strictures. The ability of aspirin and NSAIDs to inhibit the activities of cyclooxygenase (COX) contributes to the cytotoxicity of these drugs in the gastrointestinal tract. However, many studies found that, in the small intestine, COX-independent mechanisms are the main contributors to NSAID cytotoxicity. Bile and Gram-negative bacteria are important factors in the pathogenesis of NSAID enteropathy. Here, we focus on a promising strategy to prevent NSAID-induced small intestine injury. Selective COX-2 inhibitors, prostaglandin derivatives, mucoprotective drugs, phosphatidylcholine-NSAIDs, and probiotics have potential protective effects on NSAID enteropathy.