Circadian Variations of Gastrointestinal Mucosal Damage Detected with Transnasal Endoscopy in Apparently Healthy Subjects Treated with Low-Dose Aspirin (ASA) for a Short Period

AIM: In this study, transnasal endoscopy was used to observe the time-course changes of gastrointestinal mucosa with low-dose aspirin (ASA), and the preventive effect of rebamipide was compared with placebo. METHODS: Twenty healthy H.pylori-negative subjects were divided between those receiving 100 mg aspirin with placebo, and those receiving 100 mg aspirin+300 mg rebamipide for 7 days daily. Transnasal endoscopy was performed at 0, 2, 6 and 24 hrs on the first day, and then on the third and seventh days. RESULTS: Ulcers, in the duodenum at 24 hrs and in the antrum at 72 hrs, improved with continuous ASA. Erosions were mainly observed in the duodenum; erosions amounted to 14 at 3 days and 19 at 7 days in the placebo group. No ulcers and some erosions were mainly observed in the duodenum; erosions amounted to 5 at 3 days and 3 at 7 days in the rebamipide group. CONCLUSION: In short-term gastrointestinal damage induced by ASA, damage was observed in the duodenum most frequently, and peak damage was at 24 hrs and 72 hrs. Almost all damage improved gradually in spite of continuous ASA. Rebamipide reduced the damage of low-dose aspirin-induced GI complications.