An endoscopic study of gastroduodenal lesions induced by nonsteroidal anti-inflammatory drugs

The Use of Nonsteroidal Anti-Inflammatory Drugs and the Occurrence of Gastric Lesions Among Patients Undergoing Upper Endoscopy in a University Hospital in Brazil

“…This study also supports other studies that have evaluated endoscopic lesions in patients undergoing long treatments with NSAIDs, for instance, for a period more than 6 months, who presented a considerable frequency of gastric lesions. 25,27 Concerning the gastric erosions with hematin pigment, no detailed literature was found, since most studies encounter them in the same context as for gastric erosions. The occurrence of this lesion and its strong association with the NSAID use is of concern, since these pigments generally indicate severe harm to the mucosa that is highly associated with the topical aggression caused by the use of NSAIDs.…”

Effects of Diacerein on Indomethacin-Induced Gastric Ulceration

“…Although NSAIDs serve as effective therapy for the pain and inflammation of arthritis, they are associated with serious side effects, particularly ulceration, bleeding and perforation of the gastrointestinal tract. The NSAID-induced gastrointestinal disorders can be a serious problem especially for arthritis patients treated by long-term administration of NSAIDs [1]. The NSAID-induced gastrointestinal disorders are supposed to be due to a decrease in prostaglandin (PG), a gastric mucosal protecting factor [2], and then to tissue injury by reactive oxygen species (ROS), as superoxide anion, hydrogen peroxide, hypochlorous acid and hydroxyl radical, produced as a result of a gastric mucosa microcirculatory disorder [3][4][5][6][7].…”

Cyclooxygenase 2---implications on maintenance of gastric mucosal integrity and ulcer healing: controversial issues and perspectives

“…Conflicting results have been obtained on the predictive value of the initial number of erosions on later ulcer development 12-14. In a large multicentre study extending for more than six months, gastroduodenal ulcers were found in 37% of patients and gastric ulcers were more frequent than duodenal ulcers 15. Among other factors (table 1), advanced age, osteoarthritis, duration of current NSAID treatment, previous ulcer disease, and current co-treatment with corticosteroids have been shown to be associated with an increased risk of NSAID induced ulcers 15…”

“…Among other factors (table 1), advanced age, osteoarthritis, duration of current NSAID treatment, previous ulcer disease, and current co-treatment with corticosteroids have been shown to be associated with an increased risk of NSAID induced ulcers 1516 Another risk factor appears to be female sex 15. Overt upper gastrointestinal bleeding was observed in 41% of patients taking aspirin or NSAIDs and appears not to be higher following aspirin intake 17.…”