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

• Lee JH
• Lee YC
• Jeon SW
• Kim JW
• Lee SW
• Korean College of Helicobacter and Upper Gastrointestinal Research
• Korean Association of Gastroenterology

• KMID: 1767736
• DOI: http://doi.org/10.4166/kjg.2009.54.5.309

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