Indomethacin-associated peptic ulceration.

A review has been made of the hospital case notes of 32 patients with indomethacin-associated peptic ulceration seen over a four year period in Dunedin. Ulceration attributed to indomethacin therapy was found to particularly involve elderly women, in contrast to a predominance of males and a younger mean age at diagnosis in non-drug associated ulceration seen over the same period. The indomethacin-associated ulcer patients were more frequently complicated by haematemesis or melaena (two-thirds of cases compared to one-quarter for the group not on drugs) and relative hypochlorhydria was frequently noted at the time of gastroscopy in this group as compared to the other cases. It is suggested that patients warranting prolonged treatment with indomethacin require regular reassessment for any evidence of dyspepsia or anaemia, and that barium meal or gastroscopy are indicated for the presence of even mild abnormality of these types.