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Published on: March 15, 2020
Bleeding esophageal ulcers caused by NSAIDs
C Sugawa1, Y Takekuma, C E Lucas
1Department of Surgery, Wayne State University School of Medicine, 6-C, University Health Center, 4201 St. Antoine, Detroit, MI 48201, USA.
Surgical Endoscopy
|February 1, 1997
Summary
Nonsteroidal anti-inflammatory drug (NSAID) use can cause esophageal ulcers, leading to symptoms like anemia and pain. Early diagnosis via endoscopy and prompt treatment are crucial for healing.
Area of Science:
- Gastroenterology
- Internal Medicine
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain and inflammation.
- Esophageal injury from NSAIDs is a recognized but often underdiagnosed complication.
Observation:
- Four patients presented with NSAID-induced esophageal ulcers, confirmed by endoscopy.
- Common symptoms included anemia, retrosternal pain, and dysphagia.
- Ulcers were often large, shallow, and located in the mid-esophagus.
Findings:
- Three patients experienced bleeding esophageal ulcers requiring transfusions.
- One patient had massive bleeding successfully managed with endoscopic hemostasis.
- Endoscopic follow-up showed ulcer healing within 3-4 weeks after treatment initiation.
Implications:
- NSAID-induced esophageal ulcers have distinct endoscopic features.
- Early diagnosis through precise history and endoscopy is critical.
- Treatment involves discontinuing NSAIDs, antacids, H2 blockers, and patient counseling on medication intake.
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