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NSAIDs and the oesophagus

J C Mason1

  • 1Department of Medicine, Trafford General Hospital, Manchester, UK. john@urmston123.freeserve.co.uk

European Journal of Gastroenterology & Hepatology
|May 13, 1999
PubMed

Insights

Non-steroidal anti-inflammatory drugs (NSAIDs) damage the gastrointestinal tract by inhibiting prostaglandins. While beneficial in some esophageal models, NSAIDs are also implicated in esophageal damage.

Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) are known to cause gastrointestinal mucosal damage.
  • This damage is partly mediated by the inhibition of endogenous prostaglandin synthesis.
  • Prostaglandins (e.g., PGE2, PGI2) protect the stomach lining from NSAID-induced injury.

Purpose of the Study:

  • To explore the contrasting effects of NSAIDs and prostaglandins on the esophagus compared to the stomach.
  • To review the evidence for NSAIDs in the pathogenesis and potential treatment of esophagitis.

Main Methods:

  • Literature review of studies on NSAID and prostaglandin effects on the gastrointestinal and esophageal tracts.
  • Analysis of proposed mechanisms for NSAID-induced esophageal injury and protection.

Main Results:

  • Prostaglandins may exacerbate esophageal acid reflux and inflammation.
  • NSAIDs show theoretical benefits in some experimental esophagitis models.
  • Despite theoretical benefits, NSAIDs are frequently reported to cause esophagitis, ulceration, and strictures.

Conclusions:

  • The role of NSAIDs in esophageal pathology is complex and warrants further investigation.
  • Understanding the differential effects of NSAIDs and prostaglandins on the upper and lower gastrointestinal tract is crucial for clinical practice.

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