Gastric Mucosal Damage by different Groups of Anti - Rheumatic DrugsEndoscopic and Histopathologic Study

Abstract

60 rheumatic patients with or without upper gastrointestinal tract symptoms secondary to regular use of one of the antirheumatic drugs NSAID, corticosteroid, or Methotrexate have been investigated clinically endoscopically and histopathologically. Fifteen control patients not suffering from any rheumatic disease or under the effect of any rheumatic drugs at the time of examination were examined endoscopically and histopathologically. The rheumatic patients were divided into 3 equal groups each group comprised 20 patients of both sexes older than 18 years. They were suffering from either rheumatoid arthritis or osteoarthritis and each group received only one drug for at least 6 months before investigation, all patients were subjected to full clinical examination, endoscopical examination by one endoscopist, then multible biopsies have been taken from both stomach and duodenum, prepared and stained by different stains haematoxylin and eosin, Geimsa and PAS (Periodic Acid- Schiff reaction) for detection of H. pylori and amount of gartroduodenal lesions. Results Showed that : The NSAID, group had the highest prevalence of gastroduodenal mucosal injuries followed by the methotrexate group 'Yirich showed a limited gastroduodenal lesions, and lastly the corticosteroid in low doses 5-20 mg/day which showed the least hannfull effects on the gastroduodenal mucosa. The gastric mucosa IS the first part affected by the ingesion of the antirheumatic drugs especially NSAID5• Duodenal mucosa were affected mainly by the presence ofH-pylori organisms which is responsible for duodenal affection (duodenitis).