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dc.contributor.authorSrinivasan, Ashish-
dc.contributor.authorDe Cruz, Peter-
dc.identifier.citationScandinavian Journal of Gastroenterology 2017; 52(9): 941-947en_US
dc.description.abstractCo-prescription of acid suppressive therapy, together with advances in small bowel imaging techniques, have shifted the burden of NSAID-related toxicity from gastro-duodenal to more distal small bowel injury. Due to predominantly subclinical disease, NSAID enteropathy remains under-recognised, with an incidence of 53-80% amongst healthy short-term users, and a prevalence of 50-71% following long-term (>3 months) use. Despite their distinct pathogenesis, those at risk of NSAID-related gastro-duodenal and small bowel complications share several risk factors. Clinical complications of NSAID enteropathy such as protein-losing enteropathy, small bowel strictures and diaphragm disease, confer significant morbidity, and are often irreversible. Small bowel prophylaxis has proven of modest efficacy after short-term, high-dose NSAID use in asymptomatic patients. While selective COX-2 inhibitors are associated with fewer gastro-duodenal complications relative to non-selective NSAIDs, their comparative benefit in protecting against small bowel enteropathy remains unclear. Prophylaxis should be considered in those at high risk of small bowel complications, as treatment options for established disease remain limited; however, the optimal agent remains unclear. We propose a clinical algorithm that may help prevent, monitor, investigate, and manage the sequelae of NSAID-induced small bowel toxicity.en_US
dc.subjectCOX-1/COX-2 inhibitionen_US
dc.subjectNSAID enteropathyen_US
dc.subjectcapsule endoscopyen_US
dc.subjectdiaphragm diseaseen_US
dc.subjectRisk Factorsen_US
dc.subjectsmall bowelen_US
dc.titleReview article: a practical approach to the clinical management of NSAID enteropathy.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleScandinavian Journal of Gastroenterologyen_US
dc.identifier.affiliationGastroenterology and Hepatologyen_US
dc.identifier.affiliationDepartment of Medicine, The University of Melbourne, Melbourne, Australiaen_US
dc.type.austinJournal Article-
dc.type.austinReview-, Ashish
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.grantfulltextnone- and Hepatology-
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