[Role of non-steroidal anti-inflammatory drugs on upper gastrointestinal bleeding]

Peptic ulcer is a common complication of upper gastrointestinal (uGI) bleeding, which refers to 20% of patients with duodenal and gastric ulcer. Non-steroidal anti-inflammatory drugs (NSAIDs) use is a well-known risk factor for ulcer formation and uGI bleeding.

The evaluation of location and the cause od uGI bleeding and its association with NSDAIDs use.

We conducted a retrospective analysis of all patients hospitalized in our department from 2000 to 2001.

Upper gastrointestinal bleeding was an indication for 3% of hospitalizations in our department. The cause of the bleeding was as follows: NSAIDs use side effect in 21 (42%) patients, portal hypertension in 6 (12%), acenocumarol overdosage in 2 (4%), not specified in 17 (34%). 13 (62%) of 21 NSAIDs-users chronically ingested small doses of acetylsalicylic acid. The most common sources of bleeding were: duodenal ulcer in 20 (40%), gastric or esophageal ulcer in 10 (20%), erosive gastroduodenitis in 8 (16%), esophageal varices in 6 (12%), not specified in 2 (4%) and not specified after acenocumarol overdosage in 2 (4%). One patient had coexisting gastric and duodenal ulcers, and one patient had coexisting erosive gastritis and duodenal ulcer In NSAIDs-users group, there were 9 (43%) patients with erosive gastroduodenitis, 8 (38%) with duodenal ulcer and 4 (19%) with gastric ulcer.

On the basis of our observations we concluded that NSAIDs use (especially cardiological doses of acetylsalicylic acid) is a common cause of upper gastrointestinal bleeding. The most common source of bleeding in this group was erosive gastroduodenitis. The age over 65 years was an additional risk factor for uGI bleeding.