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]
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]
An early finding of anemia may warrant more extensive diagnostic testing such as an endoscopy or radiography in determination of NSAID gastropathy. Hematocrit and hemoglobin levels may also provide information about the extent of bleeding from perforation or hemorrhage. As NSAID induced ulcers are often asymptomatic, patient history and diagnostic tests/lab values are important in diagnosis. Endoscopy has a success rate of 90% for diagnosis of a peptic ulcer, however, it is expensive and the rate of correct diagnosis of NSAID gastropathy is high among physicians. (See Tamblyn et al 1997 study.) Radiography with barium can also detect and diagnose peptic ulcers but is less common than endoscopy.
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]
The best management for NSAID-related gastropathy is discontinued use of the NSAID. However, if this is not possible, one alternative is to prescribe a medication that reduces the gastric effects such as a PPI or an H2-receptor antagonist. The use of a PPI along with NSAIDs has shown the most positive results for prevention of NSAID-related ulcers. Futhermore, a COX-2 selective NSAID along with a PPI has shown the best results. Other treatment options include misoprostol which is a synthetic prostaglandin designed to replace those loss by NSAIDs. However, misoprotol has a lot of side effects that have proved difficult such as abdominal pain, nausea, diarrhea, and it should be avoided in pregnant women.
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),93(11): 2037-2046. Available from: MEDLINE. ..
