Mechanisms of nonsteroidal anti-inflammatory drug-induced gastric damage.
The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the gastric mucosa are well documented. The complex mechanisms of gastric damage, however, are not fully understood. This review examines current knowledge about the normal function of the gastric mucosal barrier; the role of prostaglandins in cytoprotection and repair; the mechanisms by which aspirin and other weak organic acids are absorbed by the stomach; and the subsequent cascade of events--including ion trapping and back diffusion of hydrogen ions--that leads to gastric erosion and bleeding. A hypothesis describing NSAIDs' dual insult on the stomach is advanced.
Schoen
R T
RT
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06510.
Vender
R J
RJ
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D005753:Gastric Mucosa / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D013272:Stomach Diseases / Q000139:chemically induced*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin