Increased Gastric Mucus Secretion Alleviates Non-Steroidal Anti-Inflammatory Drug-Induced Abdominal Pain

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause dyspeptic symptoms, including abdominal pain. Gastric mucus is important as the first line of defense against luminal irritants. In the present study, we investigated whether gastric mucus secretion could influence the severity of gastric mucosal injuries or NSAID-induced dyspeptic symptoms. Fifteen Helicobacter pylori-negative, healthy males were administered two types of NSAIDs, a non-selective cyclooxygenase inhibitor, naproxen (300 mg, twice a day), or a cyclooxygenase-2-selective inhibitor, etodolac (200 mg, twice a day), for 1 week in a crossover study, with an interval of ≥ 4 weeks. Study participants underwent endoscopic examinations before and after treatment. Pentagastrin-stimulated gastric secretions were collected for 10 min during endoscopic examinations, and were analyzed for gastric acid levels (mEq/10 min) and mucus output (mg hexose/10 min). The grade of gastric mucosal injury was assessed endoscopically. Among 29 subjects who completed the crossover study, 11 individuals reported abdominal pain following the administration of naproxen or etodolac for 1 week, as judged by elevated pain scores, while 18 individuals did not report abdominal pain. The occurrence of symptoms was not associated with the type of NSAIDs administered or the occurrence of erosive injury visualized by endoscopy. Gastric mucus secretion was significantly increased in subjects without drug-induced abdominal pain (P < 0.05), whereas it was significantly reduced in those with drug-induced abdominal pain (P < 0.05). In conclusion, the occurrence of NSAID-induced abdominal pain is associated with reduced levels of gastric mucus secretion rather than the occurrence of endoscopic mucosal injury.

Cylindrospermopsin-Microcystin-LR Combinations May Induce Genotoxic and Histopathological Damage in Rats

“…In contrast, significantly altered gastric mucus secretions were found previously after oral administration of MC-LR in mice [87] or pure CYN in rats [43]. These lesions were associated with an irritant effect of the toxins since the gastric mucus is the first line of defense against luminal irritants [43,88]. However, the discrepancies could be associated with the age of the animals [87] or the time of exposure, which was longer in the study of Diez-Quijada et al [43].…”

A Chronological Increase in Gastric Acid Secretion from 1995 to 2014 in Young Japanese Healthy Volunteers under the Age of 40 Years Old

“…In a series of our previous studies (Iijima et al 1998(Iijima et al , 2009Iwabuchi et al 2013;Shinkai et al 2014), we enrolled 95 healthy male volunteers to investigate their gastric acid secretion level with the endoscopic gastrin test (EGT) described below over the 20-year time period from 1995 to 2014. These healthy volunteers had been recruited mainly from Tohoku university students or post-graduate students, and they were not included in our preceding report comprising hospital outpatients (Iijima et al 2015).…”