NSAID Gastropathy
Original Editors - Amanda Huber & Emily Sipe from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
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Prevalence[edit | edit source]
- "Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) taking NSAIDs have an ulcer incidence of approximately 15-20%" [1]
- “Although a 15-25% incidence of gastric and/or duodenal ulcer has been demonstrated in all patients taking NSAIDs, the bleeding rate is estimated by most experts at only 2-4%”. [1]
- Approximately 1 in 10 ulcers from NSAIDs bleeds. [1]
- “In elderly patients taking NSAIDs the relative risk of GI surgery is 10 times, and for GI cause of death, about 4.5 times greater than in control groups” [1]
- “Approximately 20 million patients in the US take NSAIDs on a regular basis; the risk for hospitalization for serious GI adverse effects is 1-2%, resulting in approximately 200,000 to 400,000 hospitalizations per year at an average cost of $4,000 per patient, or 0.8-1.6 billion dollars annually” [1]
- “An increased risk of GI bleeding has even been noted in patients taking low dose aspirin therapy for cardiovascular prophylaxis” [1]
- “Gastric and duodenal lesions were more common in patients who took NSAIDs for <3 months, whereas patients with a longer duration of therapy tended to have more lesions in the small bowel and colon” [1]
- “Some recent studies have shown that the incidence of duodenal ulcer is increased in Helicobacter pylori-positive patients taking NSAIDs…It has been recently reported that eradication of H.pylori before NSAID therapy strikingly reduces the incidence of ulcer disease in patients being treated with naproxen.” [1]
- “Among individuals with arthritis, almost 30% report daily use of OTC NSAIDs…Safety often is not considered or well understood among consumers of OTC NSAIDS until after the occurrence of adverse events such as gatsropathy” Roth
Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ Lanza F. A guideline for the treatment and prevention of NSAID-induced ulcers. Members of the Ad Hoc Committee on Practice Parameters of the American College of Gastroenterology. The American Journal Of Gastroenterology [serial on the Internet]. (1998, Nov), [cited March 5, 2013]; 93(11): 2037-2046.
