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Thursday 26 December 2024

Peer Reviewed

Gastroenterology clinic

How I prescribe NSAIDS in patients with a previous gastric ulcer

Jason Grant

Recent articles on:
Peptic ulcer

Helicobacter pylori infection: when to search for it and how to diagnose it

Towards a diagnosis of functional dyspepsia

Helicobacter pylori: to treat or not to treat

Peptic ulcer disease: an update on diagnosis and treatment

How I manage asymptomatic patients with positive H. pylori serology

Recent articles on:
Digestive diseases

Dysphagia – an updated guide to investigation

Anal disorders – haemorrhoids, abscesses and fissures

Coeliac disease – optimising long-term management

Irritable bowel syndrome: an update on diagnosis and management

Is heartburn always reflux? An update on gastro-oesophageal reflux

Abstract

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.

Key Points

Remember

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.