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Can Gastroduodenal Ulcers in NSAID Users Be Prevented?

Mark Feldman
[+] Article, Author, and Disclosure Information

University of Texas Southwestern Medical Center, Department of Veterans Affairs Medical Center, Dallas, TX 75216. Requests for Reprints: Mark Feldman, MD, Department of Veterans Affairs Medical Center, (111), 4500 South Lancaster Road, Dallas, TX 75216. Grant Support: By the Department of Veterans Affairs and the Southland Financial Corporation Distinguished Chair in Geriatrics.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;119(4):337-339. doi:10.7326/0003-4819-119-4-199308150-00015
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Numerous epidemiologic and endoscopic studies have shown that regular use of prostaglandin synthesis inhibitors such as aspirin or other NSAIDs can lead to gastroduodenal [1] and intestinal ulcers [2]. It is not unusual for a regular NSAID user to have a life-threatening ulcer complication (bleeding or perforation). Among persons who ingest NSAIDs regularly, how often do clinically important ulcers occur? The answer to this important question is not yet known. It has been stated that symptomatic ulcers (that is, ulcers associated with pain or a complication such as bleeding or perforation) occur in approximately 1% of patients after use of nonsalicylate NSAIDs for 3 to 6 months and in 2% to 4% of patients after 1 year [3]. Further, no subset of patients who are not at risk for NSAID-related ulcers has been identified [3]. Can these symptomatic ulcers be prevented?

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