naa a22 4500 510814204 CHVBK 20180411083457.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s12328-013-0424-8 doi (NATIONALLICENCE)springer-10.1007/s12328-013-0424-8 Latest concepts on the association between nonsteroidal anti-inflammatory drug-induced small intestinal injury and intestinal bacterial flora [Elektronische Daten] [Shunji Fujimori, Choitsu Sakamoto] Luminal bacteria, one of the main aggressive factors of nonsteroidal anti-inflammatory drugs (NSAIDs), induce small intestinal mucosal injury. Because most bacteria invading from the mouth are eliminated by the highly acidic gastric environment, the upper small intestine contains relatively low numbers of microorganisms. With decreased peristalsis, decreased acidity, and lower oxidation-reduction potential, the ileum maintains a more diverse microflora and a higher bacterial population. As NSAID-induced small intestinal ulcerations tend to localize in the small intestinal distal part, as viewed by capsule endoscopy, the ulcers are in contact with a large amount of luminal bacteria. Recently, it was reported that proton-pump inhibitors (PPIs) exacerbate NSAID-induced small intestinal injury in rats. The study showed that PPIs impair the ability to disinfect due to the PPI-induced low acidic gastric environment, and this resulted in transubstantiation of intestinal flora which exacerbated NSAID-induced small intestinal injury. If it is true that PPIs exacerbate small intestinal injury, the methods of preventing NSAID-induced gastroduodenal injury to defend PPI-induced small intestinal injury should be reconsidered. Following several studies, there may be a possibility that probiotics and prebiotics are useful treatments for the prevention of NSAID-induced small intestinal injury. A method of determining bacterial flora maintenance including alteration of the environment and the administration of various drugs is required. Springer Japan, 2013 Small intestine nationallicence NSAID nationallicence PPI nationallicence Flora nationallicence Bacteria nationallicence Fujimori Shunji Department of Gastroenterology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Sakamoto Choitsu Department of Gastroenterology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Clinical Journal of Gastroenterology Springer Japan 6/5(2013-10-01), 345-351 1865-7257 6:5<345 2013 6 12328 https://doi.org/10.1007/s12328-013-0424-8 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12328-013-0424-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fujimori Shunji Department of Gastroenterology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Sakamoto Choitsu Department of Gastroenterology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 773 0- Clinical Journal of Gastroenterology Springer Japan 6/5(2013-10-01), 345-351 1865-7257 6:5<345 2013 6 12328 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer