The management of non-steroidal anti-inflammatory drug-induced gastroduodenal ulcers

The risks associated with NSAID-induced gastroduodenal lesions are now relatively well defined. Identification of high-risk patients is important for prophylactic treatment or for maintenance treatment with gastric acid-suppressing medication during NSAID therapy. If patients develop a gastric ulcer and continue to take NSAIDs, all available evidence suggests that strong acid-suppressing therapy is important. Good healing rates have been described with conventional doses of H2 antagonists, but studies with higher doses have to be awaited. Small prepyloric or antrum ulcers will probably react well to conventional H2 antagonists; larger crater-like ulcers are probably best treated with omeprazole. When patients develop a duodenal ulcer and continue to take NSAIDs, all available evidence suggests that excellent treatment results can be obtained with conventional doses of H2 antagonists.