Treatment and prevention of nonsteroidal anti-inflammatory drug induced gastrointestinal mucosal injury.

It is generally recognized that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause varying degrees of gastroduodenal mucosal damage. These agents are most frequently used by physicians for rheumatic diseases because of their high effectiveness in reducing joint pain and swelling. Four classes of drugs, namely histamine (H2) blockers, antacids, sucralfate and prostaglandins are available for treatment of gastric mucosal damage caused by NSAIDs. All these drugs are very effective in healing gastric and duodenal injury if nonsteroidal anti-inflammatory drugs are discontinued. However, current data suggest that if nonsteroidal anti-inflammatory drugs are continued while gastrointestinal damage is present there may be significant differences among these drugs in healing of gastric mucosal damage. Synthetic prostaglandins are therapeutically superior over other forms of treatment when nonsteroidal anti-inflammatory drugs are continued in the presence of gastric mucosal injury. This article is a review of such data from the literature for a) the treatment and b) the prevention of gastrointestinal damage due to aspirin and nonsteroidal anti-inflammatory drugs.