Is there a relationship between the use of analgesics and non-steroidal anti-inflammatory drugs and acute upper gastrointestinal bleeding? A Finnish case-control prospective study.
BACKGROUND
Our object was to study the role of non-steroidal anti-inflammatory drugs (NSAIDs) as a risk factor in upper gastrointestinal bleeding.


METHODS
Forty-eight patients with acute bleeding due to esophagitis, gastric or duodenal ulcer, or erosions and 156 age- and sex-matched control patients from the same emergency units were interviewed about the history of ulcer disease, smoking and alcohol habits, and use of analgesics or NSAIDs.


RESULTS
Twenty-four patients (50%) and 90 controls (57.6%) had no previous upper abdominal symptoms (NS). There were more heavy smokers among patients (n = 9; 18.8%) than controls (n = 7; 4.5%) (p < 0.01). Five patients (10.4%) and one control (0.6%) had taken more than 20 drinks during the week before admission (p < 0.001). Twenty-nine patients (62.5%) and 81 controls (51.9%) had used some analgesics during the week before admission (NS). There was no difference in the duration of the use of analgesics in the patients and controls.


CONCLUSIONS
The results do not support the concept that NSAIDs are a major factor associated with serious upper gastrointestinal bleeding.
Dept. of Surgery, Tampere University Hospital, Finland.
M
M
Matikainen
E
E
Kangas
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016022:Case-Control Studies; D004378:Duodenal Diseases / Q000139:chemically induced; D004935:Esophageal Diseases / Q000139:chemically induced; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects; D013272:Stomach Diseases / Q000139:chemically induced
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal