Nonsteroidal Anti-inflammatory Drugs and the Gut

Bi, Hirschowitz

doi:10.1097/00007611-199603000-00001

Cited by 18 publications

(7 citation statements)

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“…However, hyper-regenerative esophagopathy can be considered a consequence of GERD only when the patient shows the corresponding symptoms, and when the symptoms and the histologically diagnosed hyperregenerative esophagopathy persist under PPI therapy. Of course, similar histological alterations also can be attributed to other causes and to a damaged squamous epithelium of the esophageal mucosa, for example in the margin or after the regeneration of mechanically or chemically induced lesions [33,34], in cases of motility impediments of the esophagus [35], consumption of high-proof alcoholic drinks [36], and in infectious esophagitis (viral, bacterial, mycotic) [37]. GERD can be considered seriously if this hyper-regenerative esophagopathy is noted in patients with reflux symptoms that react to PPI, and in the lower esophagus of NERD and ERD patients.…”

Section: Discussionmentioning

confidence: 97%

What Parameters Are Relevant for the Histological Diagnosis of Gastroesophageal Reflux Disease without Barrett’s Mucosa?

Vieth

Peitz²,

Labenz³

et al. 2004

Dig Dis

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Background/Aims: There are still ongoing controversies as to which histological parameters allow the diagnosis of gastroesophageal reflux disease (GERD). The aim of the present analysis was to relate histological changes of the esophageal squamous epithelium to different severities of GERD. Methods: Data were obtained from patients participating in the ProGERD study, who had either erosive reflux disease (ERD, n = 3,245) or non-erosive reflux disease (NERD, n = 2,970). 1,475 patients fulfilled our requirement of having complete biopsy data from two sites (2 cm above the z-line and at the z-line). Changes in the squamous epithelium were assessed by measuring the thickness of the basal cell layer and elongation of the papillae as a percentage of the whole epithelial thickness and counting interepithelial inflammatory cells. Results: The most useful parameters for histological assessment of GERD (given as means, 2 cm above the z-line and at the z-line, respectively) were elongation of the papillae: NERD 40.7 and 48.9%; ERD 46.1 and 54.9% and basal cell hyperplasia: NERD 12.7 and 17.9%; ERD 15.7 and 23.0%. The occurrence of intraepithelial lymphocytic infiltrates, however, is dependent on the severity of GERD, and they are more common than neutrophilic and eosinophilic granulocytes. Conclusion: This study shows that both NERD and ERD can be diagnosed histologically if biopsies are obtained from the distal esophagus or from the z-line. Intraepithelial inflammatory cells are rare and show a high specificity, but very low sensitivity.

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Section: Discussionmentioning

confidence: 97%

What Parameters Are Relevant for the Histological Diagnosis of Gastroesophageal Reflux Disease without Barrett’s Mucosa?

Vieth

Peitz²,

Labenz³

et al. 2004

Dig Dis

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“…NSAIDs are used after surgery as preventive (before surgical incision) or therapeutic (after anaesthesia effect) analgesics and anti-inflammatories aiming to block the liberation of substances that change the excitation threshold in peripheral nocireceptors and alleviate moderate or mild intensity pain 5 .…”

Section: Introductionmentioning

confidence: 99%

Diclofenac sodium and Imipenem action on rat intestinal mucosa: a biomechanical and histological study

et al. 2012

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PURPOSE:To study diclofenac sodium induced histological and mechanical alterations and their prevention with Imipenem in rat intestine. METHODS: Male Wistar rats (n=240) were randomly assigned to four experimental groups: GI: n=60 treated with 0.9% saline IM; GII: n=60 treated with 6mg/kg body weight diclofenac sodium IM for four days; GIII: n=60 treated with 30mg/kg body weight Imipenem IM for four days, and GIV n=60 treated with diclofenac sodium plus Imipenem at the above doses IM for 4 days. Each group was further divided into 4 subgroups of 15 rats each and sacrificed at 4, 7, 14, and 21 days of follow-up, respectively. Abdominal cavity macroscopy and histology, and small bowel breaking strength were analyzed at each sacrifice moment. RESULTS: There were no histological or mechanical alterations in normal control rats throughout the study. Ulcerated lesions in intestinal mucosa were observed and breaking strength decreased in all diclofenac sodium treated rats. Ulcerated lesions in intestinal mucosa were prevented by Imipenem in all rats. CONCLUSION: Diclofenac sodium induced ulcerated lesions in rat intestinal mucosa can be prevented by Imipenem treatment. Key words: Diclofenac. Imipenem. Intestine, Small. Ulcer. Rats. RESUMO OBJETIVO:Avaliar as alterações histológicas e biomecânicas do diclofenaco de sódio na mucosa intestinal do rato e a associação com o uso de Imipenem. MÉTODOS: Foram estudados 240 ratos Wistar distribuídos aleatoriamente em quatro grupos experimentais: GI: 60 ratos tratados com injeção IM de soro fisiológico 0,9%; GII: 60 ratos tratados com injeção IM de diclofenaco de sódio na dose de 6mg/kg de peso por 4 dias; GIII: 60 ratos tratados com injeção IM de Imipenem na dose de 30 mg/kg de peso por 4 dias; GIV: 60 ratos tratados com injeção IM de soro fisiológico e diclofenaco de sódio nas doses acima. Em cada grupo os animais foram posteriormente divididos em 4 momentos de 15 animais em cada um para sacrifício, respectivamente, no 4º, 7º, 14º e 21º dias após o início do tratamento. As alterações da cavidade abdominal, assim como as características histológicas e de força de ruptura do intestino delgado foram analisadas em cada momento, em cada grupo. RESULTADOS: Não foram encontradas alterações histológicas e biomecânicas nos animais do Grupo I nesse estudo. Lesões ulceradas na mucosa do intestino delgado foram observadas nos animais tratados com diclofenaco de sódio, assim como diminuição da força de ruptura. As lesões ulceradas encontradas foram prevenidas pelo uso de Imipenem. CONCLUSÃO: O diclofenaco de sódio induz lesões ulceradas na mucosa intestinal do rato que podem ser prevenidas pelo uso de Imipenem. Descritores: Diclofenaco. Imipenem. Intestino Delgado. Úlcera. Ratos.Junior IG et al.

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“…NSAID-related upper gastrointestinal symptoms can markedly impair patients' quality of life 26,27 and may necessitate dose reduction or discontinuation of treatment. 28,29 …”

mentioning

confidence: 99%

Nonsteroidal anti‐inflammatory drug use as a risk factor for gastro‐oesophageal reflux disease: an observational study

Ruszniewski

Soufflet

Barthélémy

2008

Aliment Pharmacol Ther

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Nonsteroidal Anti-inflammatory Drugs and the Gut

Cited by 18 publications

References 0 publications

What Parameters Are Relevant for the Histological Diagnosis of Gastroesophageal Reflux Disease without Barrett’s Mucosa?

What Parameters Are Relevant for the Histological Diagnosis of Gastroesophageal Reflux Disease without Barrett’s Mucosa?

Diclofenac sodium and Imipenem action on rat intestinal mucosa: a biomechanical and histological study

Nonsteroidal anti‐inflammatory drug use as a risk factor for gastro‐oesophageal reflux disease: an observational study

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