[Treatment of NSAIDs related dyspepsia].
NSAIDs-induced dyspepsia occurs in 10 to 30% of patients treated with NSAIDs, leading to discontinuation of treatment in 5 to 15%. Gastrointestinal tolerability of COX-2 selective inhibitors is better than for non-selective NSAIDs. Helicobacter pylori infection does not influence gastrointestinal tolerability of NSAIDs. Therefore, patients should not be tested and treated for H. pylori infection unless they have a history of peptic ulcer. Symptoms of NSAIDs-induced dyspepsia are poorly correlated with gastroduodenal mucosal damage. Therefore, upper gastrointestinal endoscopy should be performed only if symptom relief is not achieved with the first line empirical treatment and/or if symptoms suggestive of complications, such as bleeding, develop. Proton pump inhibitors appear to be the treatment of choice for NSAIDs-induced dyspepsia.
Zerbib
Frank
F
Service d'Hépato-Gastroentérologie, Hôpital Saint-André, Bordeaux. frank.zerbib@chu-bordeaux.fr
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D004415:Dyspepsia / Q000139:chemically induced* / Q000188:drug therapy*; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000175:diagnosis; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans
D000894:Anti-Inflammatory Agents, Non-Steroidal
Prise en charge de la dyspepsie chez les patients traités par AINS.