Importance of Prophylactic Strategies in Prevention of Gastrointestinal Injuries by Nonsteroidal Antiinflammatory Drugs (Сlinical case)

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are most widely used medications in clinical practice due to their antiinflammatory, analgesic and antipyretic effects. They are usually well tolerated, but in patients with certain risk factors this group of drugs can have a negative influence on the digestive tract (DT) and the cardiovascular system. The results of numerous studies present that all NSAIDs, without exception, can also cause complications of kidney function. Side effects from DT are the most dangerous because of their high frequency and severity. In a third of patients who take NSAIDs symptoms of dyspepsia and gastroesophageal reflux are developed. NSAID-associated gastrointestinal damage has been found to extend beyond the duodenum. It has been confirmed that the frequency of bleeding caused by enteropathy is higher than in gastropathy caused by NSAIDs. New diagnostic methods such as capsule endoscopy and balloon endoscopy have made available and demonstrative negative impact of NSAID use and the need for preventive strategies to the general medical public. Intestinal damage, including inflammation, mucosa erosions, and ulcers, as well as more serious clinical outcomes such as perforation and diverticulitis, have been reported in patients taking long-term NSAIDs. The article presents the results of our own clinical observations of a case of multiple perforations of the intestine with uncontrolled long-term use of various NSAIDs by a patient with severe comorbid pathology. When prescribing NSAIDs, doctors should carefully collect the patient’s medical history regarding concomitant diseases and the drugs he is taking. Today, the effective and safe selection of NSAIDs remains a problem in the clinical practice of a doctor of any specialty, which motivates further searches for preventive strategies to prevent the development of enteropathy with long-term use of NSAIDs.