Su1121 - Small Bowel and Other GI Lesions in Obscure Gastrointestinal Bleeding and Low Dose Aspirin vs. Nsaids. Screening Phase of the Masters Trial

Abstract

Introduction While NSAIDs can affect any part of the GI tract, little is known about the effect of aspirin in the small bowel or colon. In this prospective analysis, we compared upper GI, small bowel, and colonic findings in patients taking aspirin vs. those taking NSAIDs while being considered in the screening phase of the MASTERS Trial (Misoprostol for the Healing of Small Bowel Ulceration in Patients with Obscure Blood Loss while Taking Low-Dose Aspirin or Non-Steroidal Anti-inflammatory Drugs). Method For MASTERS, obscure occult bleeding was defined as having absence of potentially bleeding lesions on colonoscopy and endoscopy, and in the presence of one or more of the following: positive faecal occult blood test; iron deficiency anaemia; or drop in Hb, > 2 gm/dl from baseline. Suitable patients underwent small bowel video capsule endoscopy (Omom systems, China). Results DEMOGRAPHY: 127 patients were assessed: 80 taking aspirin alone without NSAIDs and 47 taking NSAIDs alone without aspirin; they all had colonoscopy while smaller numbers underwent upper GI or capsule endoscopy. The aspirin group had older patients (median 69 vs. 61 years, p Conclusion (1) In this prospective analysis, patients with obscure occult bleeding and using aspirin have similar prevalence and range of lesions in the small bowel and upper GI tract as those using NSAIDs. (2) The use of NSAIDs was associated with fewer patients with colonic polyps. These results might help in planning and interpreting the investigations of obscure bleeding. They might also be relevant to colon cancer chemoprevention. Disclosure of Interest None Declared