Symptoms
of osteoarthritis are frequently treated with nonsteroidal inflammatory
drugs (NSAIDS), but chronic use of these drugs can cause serious
damage to the gastrointestinal (GI) system. An abundance of literature
clearly delineates the causative role of these medications in triggering
dyspepsia, ulcers, lesions, and other problems.1-5 Increased permeability
and inflammation are also associated with chronic NSAID use.6 Once
the intestinal mucosa is damaged, bacteria, toxins, and allergens
normally prevented from penetrating the GI system can permeate into
the bloodstream, where they are carried into all parts of the body,
both triggering and exacerbating symptoms.
One study of osteoarthritis patients taking NSAIDS found that over
50% exhibited at least one type of gastroduodenal damage.7 Another
study found an even higher rate--68%--and concluded that "fairly
severe gastroduodenal injury occurs in asymptomatic patients with
rheumatoid and osteoarthritis"8. Most importantly, these researchers
also noted that symptoms do not necessarily predict the degree of
GI tract damage. Because endoscopy is a costly and invasive procedure,
clinicians have recommended using non-invasive tests of intestinal
permeability to first identify patients who may benefit from further
analysis, as well as to monitor response to treatment.9
The
Intestinal Permeability Assessment is a non-invasive
lactulose-mannitol challenge that provides crucial information about
the integrity of the intestinal mucosa.
The
Comprehensive Digestive Stool Analysis provides an in-depth
look at digestive function, microbial balance, absorption, immunology
and other parameters of gut health that can be impacted by the etiology
and treatment of osteoarthritis.
References
1 Cryer B, Kimmey MB. Gastrointestinal side effects of nonsteroidal
anti-inflammatory drugs. Am J Med 1998;105(1B):20S-30S.
2 Price AH, Fletcher M. Mechanisms of NSAID-induced gastroenteropathy.
Drugs 1990;40 Suppl 5:1-11.
3 Zalev AH, Gardiner GW, Warren RE. NSAID injury to the small intestine.
Abdom Imaging 1998;23(1):40-4.
4 Hirschowitz BI. Nonsteroidal antiinflammatory drugs and the gastrointestinal
tract. Gastroenterologist 1994;2(3):207-23.
5 Wallace JL. The 1994 Merck Frosst Award. Mechanisms of nonsteroidal
anti-inflammatory drug (NSAID) induced gastrointestinal damageÑpotential
for development of gastrointestinal tract safe NSAIDs. Can J Physiol
Pharmacol 1994;72(12):1493-8.
6 Aabakken L. Review article: non-steroidal, anti-inflammatory drugs--the
extending scope of
gastrointestinal side effects. Aliment Pharmacol Ther 1992;6(2):143-62.
7 Fuller R, Hirose-Pastor E, Levy M, Zaterka S, Massuda HB, Eisig
JN, Yoshinari NH. Gastrointestinal damage in osteoarthritis patients
[Portugese]. Rev Hosp Clin Fac
Med Sao Paulo 1997;52(2):47-50.
8 Larkai EN, Smith JL, Lidsky MD, Graham DY. Gastroduodenal mucosa
and dyspeptic symptoms in arthritic patiens during chronic nonsteroidal
and anti-inflammatory drug use. Am J Gastroenterol 1987;82(11):1153-8.
9 Davies NM. Review article: non-steroidal anti-inflammatory drug-induced
gastrointestinal
permeability. Aliment Pharmacol Ther 1998;12(4):303-20.
All
lab tests can be done through the mail in the privacy of your own
home, except blood tests, we send you to a lab to have your blood
drawn for these. After you pay for the test we mail you the kit,
the results take two weeks, the test results will be mailed to us
and we will call you to go over the results, its that easy! All
tests include the consultation for the report of findings.
Click
on area of interest on the right for more information.
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