Gastroenterology clinic

How I prescribe NSAIDS in patients with a previous gastric ulcer

Jason Grant



In the USA, gastrointestinal complications caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are thought to cause approximately the same number of deaths each year as HIV. Here, Jason Grant presents his approach to minimising peptic ulceration, perforation and haemorrhage.

Article Extract

  • A previous gastric ulcer doubles the risk of serious NSAID gastrotoxicity.
  • In patients taking NSAIDs, most developing ulcers (but not all) are gastric.
  • Older patients are at greater risk of an NSAID complication, especially beyond the age of 65 years.
  • Concomitant oral corticosteroids, oral anticoagulants and cigarette smoking potentiate the toxic effects of NSAIDs.