NSAID association with gastrointestinal bleeding and peptic ulcer.
This paper reviews recent data describing the increased risk of bleeding and peptic ulcer with NSAID use in arthritis and non-arthritis populations. We briefly report personal studies on both aspects. By objective testing in 66 GI bleeders the use of NSAIDs, especially ASA, was more strongly associated with GI bleeding from both ulcer and non-ulcer sources, including colonic, than previously reported (82% vs. 21% in controls). ASA abuse, often surreptitious, may account for many, if not most, treatment-resistant peptic ulcers. We report 29 such patients. Adverse effects of NSAID use add considerably to economic cost, excess morbidity and mortality, especially in the elderly. Bleeding and peptic ulcer are separate risks of NSAID use. This conclusion carries major implications for prophylaxis strategies.
Hirschowitz
B I
BI
Division of Gastroenterology, University of Alabama, Birmingham 35294.
Lanas
A
A
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000517:prevention & control; D006801:Humans; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000517:prevention & control
D000894:Anti-Inflammatory Agents, Non-Steroidal