Korean J Gastroenterol.  2009 Nov;54(5):309-317. 10.4166/kjg.2009.54.5.309.

Guidelines of Prevention and Treatment for NSAID-related Peptic Ulcers

Affiliations
  • 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
  • 4Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Institute of Digestive Diseases and Nutrition, Korea University College of Medicine, Seoul, Korea. leesw@kumc.or.kr

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications in Korea. Gastrointestinal toxicity, including peptic ulcer, is a common adverse effect of NSAIDs. Risk factors for NSAID-related peptic ulcer include a previous history of peptic ulcer, advanced age, high dose, concomitant use of corticosteroids, anticoagulants, other NSAIDs including low-dose aspirin. Preventive measure(s), such as COX-2 inhibitor, proton pump inhibitor or misoprostrol, should be done for patients requiring NSAID therapy who have high-risk factor(s) for peptic ulcer. Low dose aspirin also increases the risk of peptic ulcer, so preventive measure(s) should be done for high-risk patients. The eradication of Helicobacter pylori is recommended for high-risk NSAID-users. Treatment strategies for peptic ulcers in NSAID users are mostly the same for peptic ulcers in NSAID non-users.

Keyword

Non-steroidal anti-inflammatory drug; Peptic ulcer; Prevention; Guideline

MeSH Terms

Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
Anti-Ulcer Agents/therapeutic use
Anticoagulants/adverse effects
Aspirin/*adverse effects
Cyclooxygenase 2 Inhibitors/therapeutic use
Helicobacter Infections/diagnosis/drug therapy
Helicobacter pylori
Humans
Misoprostol/therapeutic use
Peptic Ulcer/drug therapy/prevention & control/*therapy
Proton Pump Inhibitors/therapeutic use
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