title: Frequency of nonsteroidal anti-inflammatory drug-associated ulcers.
abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for treatment of orthopedic diseases, inflammatory diseases, etc., and low-dose aspirin is a common antiplatelet therapy given mainly for secondary prevention of atherothrombosis (e.g., myocardial infarction and cerebral infarction). As to the history of NSAID-induced gastric mucosal injury in Japan, the first case of an aspirin-induced gastric ulcer was reported as early as 1934. Based on a meta-analysis of risk factors for peptic ulcers, Helicobacter pylori infection and NSAIDs are the main etiologies of peptic ulcers. NSAIDs alone increase the odds ratio for ulcer development to 19.4 and that for ulcer bleeding to 4.85. In fact, the Japan Rheumatism Foundation reported in 1991 that active gastric ulcers and active duodenal ulcers were detected in 15.5 and 1.9 % of 1008 patients, respectively, taking oral NSAIDs for 3 months or longer. In Japan, which is becoming an increasingly aged society, the numbers of patients taking NSAIDs and low-dose aspirin are expected to increase dramatically in the future. It is hoped that accumulation of evidence on gastrointestinal risk will allow many patients to rationally avoid gastrointestinal complications while receiving the benefits of NSAIDs and low-dose aspirin.
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan. hiraishi@dokkyomed.ac.jp.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hiraishi
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Oki
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Tsuchida
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Yoshitake
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tominaga
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kusano
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Maeda
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Sasai
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Tadahito
authors.initials: T
authors.lastname: Shimada
keywords: Antiplatelet therapy; Aspirin; NSAIDs; Proton pump inhibitor; Risk factors; Upper gastrointestinal bleeding