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Nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk for upper gastrointestinal bleeding. Reducing gastric acid by using proton-pump inhibitors can mitigate this risk. NSAIDs can also damage the lower gastrointestinal tract, by an acid-independent mechanism, leading to increased intestinal permeability and blood loss. Intestinal bacteria are believed to play a role in such enteropathy.
Investigators in Italy recently studied the effect of a probiotic preparation on enteropathy associated with the NSAID indomethacin. Twenty healthy volunteers were randomized to receive either a probiotic mixture of eight bacterial strains or placebo daily for 21 days. All participants received 50 mg per day of indomethacin on days 16 to 19. Stool w…