Abstract
Objective To investigate gastric and small intestinal mucosal injury in asymptomatic patients taking enteric-coated aspirin using magnetically controlled capsule endoscopy. Methods Patients taking enteric-coated aspirin (aspirin group) and healthy controls (control group) were recruited from Beijing Anzhen Hospital, Capital Medical University, between September 2017 and May 2018, and undertook magnetically controlled capsule endoscopy. Results Twenty-six subjects were recruited to the aspirin group and twenty-six to the control group; the median Gastrointestinal Symptom Rating Scale scores were 3.50 and 3.00 (P = 0.200), the median gastric Lanza scores were 2.50 and 1.00 (P < 0.001), the small intestinal Lanza scores were 1.00 and 0.00 (P < 0.001), the gastric controlled examination times were 50.0 and 51.0 min (P = 0.171), the small intestinal transit times were 240.0 and 238.0 min (P = 0.654), and the capsule excretion times were 24.0 and 24.0 hours (P = 0.956), respectively. Conclusions Rates of gastric and small intestinal mucosal injuries were significantly higher in patients without obvious gastrointestinal symptoms taking enteric-coated aspirin compared to healthy controls. Magnetically controlled capsule endoscopy constitutes a safe, real-time screening modality for gastric and small intestinal mucosal injury in patients taking enteric-coated aspirin.
Highlights
Aspirin is both a primary and secondary preventive drug for patients with cardiovascular diseases [1]
In middle-aged and elderly populations, low-dose aspirin (LDA) often leads to dyspepsia, epigastric pain, acid reflux, heartburn, and other symptoms, which reduces compliance; patients may stop taking aspirin, in turn increasing the risk of adverse cardiovascular events [15, 16]
Aspirin can injure the gastric and small intestinal mucosa at the same time; there is a lack of clinical methods allowing simultaneous screening for gastric and small intestinal mucosal injury
Summary
Aspirin is both a primary and secondary preventive drug for patients with cardiovascular diseases [1]. It injures the gastrointestinal mucosa through local and systemic actions [2, 3]. With the introduction of capsule endoscopy (CE) and double-balloon enteroscopy, reports on aspirin-related small intestinal mucosal injury are increasing year by year [4,5,6]. Gastroscopy is the most commonly used screening method for mucosal injury in the upper digestive tract. There is a lack of clinical methods to simultaneously screen for gastric and small intestinal mucosal injury in patients taking enteric-coated aspirin. The aim of this study was to screen for gastric and intestinal mucosal injury using MCCE in asymptomatic patients taking entericcoated aspirin
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