Sri Estuningsih

Dyspepsia in Nonsteroidal Anti-inflammatory Drugs Gastropathy

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) gastropathy is a common complication, which has characteristic symptoms of dyspepsia syndrome. Mostly, it includes epigastric discomfort with bloating and nausea. The aim of this study was to provide evidences that clinical symptoms of dyspepsia are related to macroscopic changes of gastric form in rats, which are expected to be applied in human. Method: The study was conducted in 20 white rats (Rattus norvegicus, Sprague-Dawley strain) at the Department of Pathology and Clinical Reproduction, Bogor Agricultural University between January and December 2008. The rats were divided to treatment group and control group and each group consisted of 10 rats. Acetyl salicylic acid (ASA/aspirin) was administered at 400 mg dose, diluted in distilled water and was given to the treatment group using gastric cannula, once daily for three days period; while the control group had received aquabidest only. Subsequently, necropsies were conducted for both groups, followed by macroscopic observation and measurement of sagittal and transversal diameter. Gastric incisions along the minor curvature were performed in both groups to recognize any macroscopic changes of gastric mucosa. ANOVA test was utilized for data analysis, which was followed by Duncan test when the results were significant. Results: Gastric diameters in treatment group with positive lesion were significantly different from the control group and the treatment group with negative lesion on anthrum/pylorus region, with p < 0.05. Conclusion: Prominent gastric dilatation at anthrum/pylorus region found in the treatment group may become the initial cause and signs of dyspepsia in human. Keywords: NSAID gastropathy, dyspepsia, NSAIDs/aspirin, gastric dilatation

Preventing NSAID-induced Gastropathy: The Role of Mucus Cells to Prevent Aspirin-Induced Acute Gastric Mucosal Damage

Background: Mucus is pre-epithelial gastric layer that may prevent damages due to direct contact between aspirin and gastric epithelial cells. The integrity of gastric mucosa and mucous cellular reaction may serve as primary and secondary prevention of extended aspirin-induced gastric mucosal damage. The aim of this study was to prove the function of mucus as defensive factor in rats. Method: The study was conducted in twenty white rats of the Sprague-Dawley strain at Department of Pathology and Clinical Reproduction, Bogor Agricultural University, between January and December 2008. The rat in the treatment group were given 400 mg aspirin diluted in aqua bidest through intra- gatric canules; while the control group received aqua bidest only once daily for 3 days. Necropsies, macroscopic and microscopic observation were performed by counting the number of Alcian blue- periodic acid Schiff-stained mucous cells at fundus/corpus and antrum/pylorus regions. Data analysis was performed using ANOVA and Duncan test. Results: The number of mucous cells with positive lesions in the treatment group was significantly different from the control group at both regions. There was no significant difference of negative lesions between treatment and control group at both regions. At antrum/pylorus region, there was no difference of negative lesions between treatment and control groups; however, both groups demonstrated significant difference of positive lesions in treatment group. Conclusion : In primary prevention for gastric mucosal lesions, there is no increasing number of mucous cells in normal mucosa. Increasing number of mucous cells is a secondary prevention against extended aspirin-induced gastric mucosal damage. Keywords : NSAIDs/ASA, mucus cells, gastric mucosal lesion, rat