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Omeprazole increased small intestinal mucosal injury in two of six disease‐free cases evaluated by capsule endoscopy
Author(s) -
Fujimori Shunji,
Takahashi Yoko,
Tatsuguchi Atsushi,
Sakamoto Choitsu
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12188
Subject(s) - omeprazole , capsule endoscopy , medicine , gastroenterology , capsule , endoscopy , small intestine , proton pump inhibitor , mucosal lesions , intestinal mucosa , biology , botany
Recently, a report showed that proton‐pump inhibitors ( PPI ) exacerbate non‐steroidal anti‐inflammatory drug‐induced small intestinal injury in the rat. In the present report of two human cases, small intestinal injuries were probably induced and/or exacerbated after PPI treatment. Case 1 was a 30‐year‐old healthy man in whom no small intestinal mucosal break was detected at baseline capsule endoscopy. After 2 weeks of omeprazole given 20 mg once daily, he was found to have two small intestinal mucosal breaks. Case 2 was a 40‐year‐old healthy man in whom six small intestinal mucosal breaks were detected at baseline capsule endoscopy. After 2 weeks of omeprazole given 20 mg once daily, 12 small intestinal mucosal breaks were detected. Follow‐up capsule endoscopy carried out 3 weeks after stopping omeprazole in case 2 showed seven small intestinal mucosal breaks were detected, showing restitution of the small intestinalmucosal injury. These two cases were obtained from a pilot study evaluating the effect of single administration of PPI on small intestinal mucosa in humans. In the pilot study, six healthy male volunteers were given omeprazole 20 mg for a period of 2 weeks. Small intestinal injury was evaluated before and after PPI treatment using capsule endoscopy. In four subjects other than the two above‐mentioned cases, no small intestinal mucosal breaks were found at both baseline and post‐treatment capsule endoscopy. Considering the two cases with increased or newly detected small intestinal mucosal breaks, omeprazole may exacerbate/induce small intestinal injury.