[Gastroduodenal lesions caused by drugs]

Nonsteroidal analgetics (NSA), in particular, can cause acute gastroduodenal erosions. Acid NSA, especially acetylsalicylic acid (ASA), damage gastric epithelium and mucosal capillary endothelium directly. In addition, gastric mucosa is made more prone to attack by aggressive factors like acid, when prostaglandin biosynthesis is inhibited by NSA. Useful studies on the relationship between these acute lesions and peptic ulceration are rare. For the greatest offender, unbuffered ASA, an increased risk for gastric ulceration is documented after prolonged use of higher doses. Major bleeding from peptic ulcers and erosions seems likewise to be fostered. With newer NSA, the damaging potency is, in general, smaller.