Nonsteroidal anti-inflammatory drugs and gastrointestinal disease: pathophysiology, treatment and prevention.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a common cause of gastrointestinal ulceration. Chronic NSAID use increases the risk of ulcer bleeding or perforation 3- to 4-fold. NSAID-induced injury results from both local effects and systemic prostaglandin inhibition. New evidence suggests that the systemic effects on prostaglandin production may vary between NSAIDs. The majority of NSAID-induced ulcers are asymptomatic. They may be treated by discontinuing the NSAID and using standard ulcer therapy. Patients taking NSAIDs who are at a high risk for a GI complication should also receive therapy to decrease their risk for ulceration. In this review the epidemiology, pathogenesis, risks, treatment and prophylaxis of NSAID-induced gastrointestinal complications are discussed.
Bjorkman
D J
DJ
University of Utah School of Medicine, Salt Lake City, USA.
Kimmey
M B
MB
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D006801:Humans; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D010439:Peptic Ulcer Perforation / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D011448:Prostaglandin Antagonists / Q000009:adverse effects; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011448:Prostaglandin Antagonists