Prevention of nonsteroidal anti-inflammatory drug-induced gastropathy

Barry Schlansky, Joo Ha Hwang

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations


Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for their analgesic, antipyretic, and antiinflammatory properties, and aspirin is increasingly employed in the primary and secondary prevention of cardiovascular disease and ischemic stroke. Despite undisputed therapeutic efficacy for these indications, all NSAIDs impart a considerable risk of peptic ulcer disease and upper gastrointestinal hemorrhage. A growing body of evidence supports an association between non-aspirin NSAIDs and acute coronary syndromes, and an expanding understanding of the gastroduodenal effects of aspirin, COX-2 selective agents, clopidogrel, and Helicobacter pylori synergism fuel controversies in NSAID use. In this review, we discuss risk stratification of patients taking NSAIDs and the appropriate application of proven gastro-protective strategies to decrease the incidence of gastrointestinal hemorrhage based upon an individualized assessment of risk for potential toxicities. Prevention of NSAID-related gastropathy is an important clinical issue, and therapeutic strategies for both the primary and secondary prevention of adverse events are continually evolving.

Original languageEnglish (US)
Pages (from-to)44-52
Number of pages9
JournalJournal of Gastroenterology
Issue numberSUPPL. 19
StatePublished - 2009
Externally publishedYes


  • Duodenal ulcer
  • Gastric ulcer
  • Gastropathy
  • Nonsteroidal anti-inflammatory drugs
  • Peptic ulcer disease

ASJC Scopus subject areas

  • Gastroenterology


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