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Review
. 2001 Nov 24;323(7323):1236-9.
doi: 10.1136/bmj.323.7323.1236.

ABC of the upper gastrointestinal tract: Indigestion and non-steroidal anti-inflammatory drugs

J M Seager  1 , C J Hawkey
Affiliations
Review

ABC of the upper gastrointestinal tract: Indigestion and non-steroidal anti-inflammatory drugs

J M Seager et al. BMJ. .
No abstract available

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Figures

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Figure
Three ulcers (one bleeding) in the gastric antrum caused by NSAIDs. Such ulcer complications are estimated to cause up to 16 500 deaths each year in the United States and 2000 deaths a year in Britain
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Figure
Hospitalisations due to complications associated with NSAID use are a problem in elderly patients
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Figure
In 1938 Douthwaite and Lintott provided the first endoscopic evidence that aspirin caused gastric mucosal damage. Images show gastric antrum before (left) and after (right) administration of aspirin (reproduced from Douthwaite AH, Lintott JAM. Lancet 1938;ii:1222-5)
Figure
Figure
Inhibition of cyclo-oxygenase enzymes by NSAIDs relieves inflammation and pain but also removes mucosal protection of gastric epithelium
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Algorithm for managing gastrointestinal side effects of NSAIDs
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Chemical (type C) gastritis showing oedema and mild chronic inflammation of lamina propria and vertical smooth muscle fibres and slight foveolar hyperplasia. Contrast with H pylori induced gastritis, which has a marked neutrophil infiltrate in the lamina propria and deeper gastric glands
Figure
Figure
Rofecoxib and celecoxib, selective COX-2 inhibitors, can relieve pain and inflammation without risking gastric ulceration
See this image and copyright information in PMC

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References

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