Abstract

Purpose: to study the frequency of lesions of the gastrointestinal tract in NSAIDs users with rheumatoid diseases, as well as to increase the effectiveness of therapeutic and preventivestrategies. Matherials and methods: 112 patients (50 men, 62 women) with various rheumatic diseases and long-term NSAIDs were examined. All patients underwent upper and lower endoscopy, in some patients video capsule endoscopy of the small intestine was also performed. Results: аccording to the data obtained, the most common NSAID-induced gastrointestinal damage was NSAID-gastropathy, observed in 43 % of all NSAID users. 68.6 % of patients with NSAID gastropathy during video capsule endoscopy were additionally diagnosed with NSAID enteropathy, and 9 % of patients with NSAID gastropathy were also diagnosed with NSAID colopathy, which were significantly more common in patients receiving non-selective NSAIDs. Combined lesions of all sections of the gastrointestinal tract, the gastroduodenal zone, small and large intestine, were observed in a significant number of patients — in 27 % of cases, most often in patients with rheumatic diseases who took non-selective NSAIDs. A generalization of the existing experience in the treatment of patients with NSAID-induced gastrointestinal lesions showed that in the case of a combination of NSAID-gastropathy and NSAID-enteropathy, the preferred preventive strategies should be H. pylori eradication, the use of rebamipide and the use of selective COX-2 inhibitors. With the combination of NSAIDs with concomitant excess bacterial growth syndrome and NSAIDs-colopathy, rifaximin, rebamipid and sulfalazine are effective. Conclusions: the data obtained confirm the high prevalence of combined lesions of the proximal and distal gastrointestinal tract in rheumatological patients, which may indicate a universal damaging effect of NSAIDs on the entire gastrointestinal tract.

Highlights

  • Для цитирования: Балабанцева А.П., Кляритская И.Л., Остапенко А.И

  • Results: аccording to the data obtained, the most common NSAID-induced gastrointestinal damage was NSAID-gastropathy, observed in 43 % of all NSAID users. 68.6 % of patients with NSAID gastropathy during video capsule endoscopy were diagnosed with NSAID enteropathy, and 9 % of patients with NSAID gastropathy were diagnosed with NSAID colopathy, which were significantly more common in patients receiving non-selective NSAIDs

  • Conclusions: the data obtained confirm the high prevalence of combined lesions of the proximal and distal gastrointestinal tract in rheumatological patients, which may indicate a universal damaging effect of NSAIDs on the entire gastrointestinal tract

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Summary

ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ

СОЧЕТАННЫЕ НПВП-ИНДУЦИРОВАННЫЕ ПОРАЖЕНИЯ ЖЕЛУДОЧНО-КИШЕЧНОГО ТРАКТА: ЧАСТОТА, КЛИНИКОЭНДОСКОПИЧЕСКИЕ ОСОБЕННОСТИ, ТАКТИКА ЛЕЧЕНИЯ. Цель: изучить частоту поражения органов желудочно-кишечного тракта (ЖКТ) у НПВП-пользователей (нестероидных противовоспалительных препаратов) при ревматологических заболеваниях, а также сравнить эффективность лечебных и профилактических стратегий. Сочетанное поражение проксимальных и дистальных отделов ЖКТ, то есть, гастро- и энтероколопатии были диагностированы в 27 % случаев, чаще всего — у больных, принимавших неселективные НПВП. Заключение: полученные данные подтверждают высокую распространенность сочетанного поражения проксимальных и дистальных отделов ЖКТ у ревматологических больных, что может свидетельствовать об универсальном повреждающем влиянии НПВП на весь ЖКТ. Сочетанные НПВП-индуцированные поражения желудочно-кишечного тракта: частота, клинико-эндоскопические особенности, тактика лечения. COMBINED NSAID-INDUCED LESIONS OF THE GASTROINTESTINAL TRACT: FREQUENCY, CLINICAL AND ENDOSCOPIC FEATURES, TREATMENT. Purpose: to study the frequency of lesions of the gastrointestinal tract in NSAIDs users with rheumatoid diseases, as well as to increase the effectiveness of therapeutic and preventivestrategies.

South Russian Journal of Therapeutic Practice
Материалы и методы
Findings
Число больных
Full Text
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