title: Superior digestive tract side effects after prolonged treatment with NSAIDs in patients with osteoarthritis.
abstract: BACKGROUND
  Anti-inflammatory drugs (NSAIDs) represent one of the classes of drugs commonly recommended for patients with osteoarthritis. These drugs have side effects that sometimes affect the digestive tract.
  
  
  METHODS
  30 patients with either axial or peripheral osteoarthritis, hospitalized between January 2013 and January 2015 in the Rehabilitation Clinic of the Clinical Emergency County Hospital of Craiova, were followed. All the patients included had upper gastrointestinal endoscopy performed, excluding patients who had a history of gastritis, endoscopically demonstrated ulcer or those with a history of gastrointestinal dyspeptic phenomena.
  
  
  RESULTS
  The endoscopic examination found acute erosive gastritis in eight cases, gastric ulcer (four cases) and duodenal ulcer (six cases). No serious complications were encountered. Four patients had no clinical manifestations with endoscopic expression. Lesions were mainly mild esophagitis (Grade I) and only in three cases, esophagitis grade II or III was found. Twelve patients (40%) had Helicobacter pylori infection and had endoscopic changes (gastric ulcer, duodenal ulcer, or gastric lesions).
  
  
  CONCLUSIONS
  The adverse effects of NSAIDs in patients with osteoarthritis vary in severity. Patient age significantly influences the severity of injuries. We have not found significant differences in the incidence of COX2 selective and non-selective NSAID-induced lesions. Pathogenic interaction between the NSAID and Helicobacter Pylori infection is most often a synergistic effect in the development of gastritis or gastroduodenal ulcer.
authors.affiliation: Department of Medical Sciences II, Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: O C
authors.initials: OC
authors.lastname: Rogoveanu
authors.affiliation: Research Center for Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Bucharest.
authors.forename: C T
authors.initials: CT
authors.lastname: Streba
authors.affiliation: Research Center for Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Bucharest ; Department of Medical Sciences I, Gastroenterology, University of Medicine and Pharmacy of Craiova, Bucharest.
authors.forename: C C
authors.initials: CC
authors.lastname: Vere
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: L
authors.initials: L
authors.lastname: Petrescu
authors.affiliation: Department of Medical Sciences II, Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: R
authors.initials: R
authors.lastname: Trăistaru
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D004724:Endoscopy; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000473:pathology; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000188:drug therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: NSAIDs; gastritis; gastrointestinal side effects; osteoarthritis; ulcer