Korean J Med.  2014 Jun;86(6):664-672.

Update on NSAIDs Related Peptic Ulcers

Affiliations
  • 1Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
  • 2Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. drchunhj@chol.com

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic, antipyretic, and anti-inflammatory properties and are widely used for treating musculoskeletal and cardiovascular diseases. Notwithstanding these therapeutic efficacies, gastrointestinal toxicity is the major health problem associated with NSAID use. NSAID-related peptic ulcers are a well-known complication due to direct mucosal injury and cyclooxygenase inhibition. Risk factors for NSAID-related peptic ulcers include a prior history of peptic ulcer; age > 65 years; high-dose NSAID therapy; and concurrent use of aspirin (including low dose), corticosteroids, or anticoagulants. In addition, Helicobacter pylori infection is an independent risk factor; therefore, eradication therapy is recommended in high-risk patients using NSAIDs. Currently, misoprostol, H2-receptor antagonists, proton pump inhibitors, and COX-2 selective inhibitors are used to prevent and treat NSAID-related peptic ulcers. Further, strategic approaches are required through appropriate NSAID use and risk factor stratification to prevent NSAID-related peptic ulcers and associated complications.

Keyword

Non-steroidal anti-inflammatory drugs; Peptic ulcer; Treatment; Prevention

MeSH Terms

Adrenal Cortex Hormones
Anti-Inflammatory Agents, Non-Steroidal*
Anticoagulants
Aspirin
Cardiovascular Diseases
Helicobacter pylori
Humans
Misoprostol
Peptic Ulcer*
Prostaglandin-Endoperoxide Synthases
Proton Pump Inhibitors
Risk Factors
Adrenal Cortex Hormones
Anti-Inflammatory Agents, Non-Steroidal
Anticoagulants
Aspirin
Misoprostol
Prostaglandin-Endoperoxide Synthases
Proton Pump Inhibitors
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