title: [Corticosteroids, non-steroidal antirheumatic agents and the gastroduodenum].
abstract: A survey is given on the damaging effect of acetylsalicylic acid, other nonsteroidal anti-inflammatory drugs (NSAID) and corticosteroids on the gastroduodenal mucosa. Especially the results of blood loss studies and endoscopic investigations are reviewed in detail. Epidemiologic data strongly support an association between frequent and heavy intake of acetylsalicylic acid and gastric ulcer as well as gastrointestinal bleeding, whereas the association with duodenal ulcers is far less clearly established. Conclusive evidence proving the superiority of other NSAID in this regard is currently unavailable. Intensive ulcer therapy making use of H2 receptor antagonists often allows healing of small ulcers with a diameter less than 1 cm despite continued treatment with low dose corticosteroids or NSAID, whereas continuation of these drugs is associated with very poor healing in ulcers larger than this size. The danger of perforation has to be taken into consideration.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001241:Aspirin / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004384:Duodenoscopy; D004386:Duodenum / Q000187:drug effects*; D005753:Gastric Mucosa / Q000187:drug effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D005773:Gastroscopy; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects*; D009780:Occult Blood; D010437:Peptic Ulcer / Q000139:chemically induced; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D001241:Aspirin
vernacular_title: Corticosteroide, nichtsteroidale Antirheumatika und Gastroduodenum.