Aspirin-induced small bowel injuries and the preventive effect of rebamipide

World J Gastroenterol. 2011 Dec 14;17(46):5117-22. doi: 10.3748/wjg.v17.i46.5117.

Abstract

Aim: To evaluate the influence of taking low-dose aspirin for 4 wk on small intestinal complications and to examine the preventive effect of rebamipide.

Methods: This study was conducted as a single-center, randomized, double-blind, cross-over, placebo-controlled study. Eleven healthy male subjects were enrolled. Each subject underwent video capsule endoscopy after 1 and 4 wk of taking aspirin and omeprazole, along with either rebamipide or placebo therapy. The primary endpoint was to evaluate small bowel damage in healthy subjects before and after taking low-dose aspirin for 4 wk.

Results: The number of subjects with mucosal breaks (defined as multiple erosions and/or ulcers) were 1 at 1 wk and 1 at 4 wk on the jejunum, and 6 at 1 wk (P = 0.0061) and 7 at 4 wk on the ileum (P = 0.0019). Rebamipide significantly prevented mucosal breaks on the ileum compared with the placebo group (P = 0.0173 at 1 wk and P = 0.0266 at 4 wk).

Conclusion: Longer-term, low-dose aspirin administration induced damage in the small bowel. Rebamipide prevented this damage, and may be a candidate drug for treating aspirin-induced small bowel complications.

Keywords: Capsule endoscopy; Healthy subjects; Low-dose aspirin; Rebamipide; Small bowel injury.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alanine / analogs & derivatives*
  • Alanine / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Ulcer Agents / therapeutic use*
  • Aspirin / adverse effects*
  • Capsule Endoscopy
  • Cross-Over Studies
  • Double-Blind Method
  • Humans
  • Intestinal Diseases* / chemically induced
  • Intestinal Diseases* / drug therapy
  • Intestinal Diseases* / prevention & control
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / injuries
  • Intestinal Mucosa / pathology
  • Intestine, Small / drug effects*
  • Intestine, Small / injuries*
  • Intestine, Small / pathology
  • Male
  • Middle Aged
  • Omeprazole / therapeutic use
  • Placebos / therapeutic use
  • Quinolones / therapeutic use*
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Anti-Ulcer Agents
  • Placebos
  • Quinolones
  • Omeprazole
  • rebamipide
  • Alanine
  • Aspirin