Gastrointestinal hemorrhages as complications of gastropathies associated with intake of nonsteroidal anti-inflammatory drugs

Aim. To examine gastroduodenal mucosa in patients treated with nonsteroidal anti-inflammatory drugs (NSAID), to evaluate the rate and severity of gastrointestinal hemorrhage (GIH) as NSAID-gastropathy manifestation by the results of clinical and device tests. Material and methods. A retrospective analysis of 2042 case histories of patients admitted to the surgical department of the Moscow city hospital N 1 in 1997-2001 with diagnosis GIH confirmed at esophagogastroduodenoscopy (EGDS). 989 patients (566 males and 423 females) had acute GIH from the upper gastrointestinal tract. Results. Relationship between intake of NSAID and GIH was documented in 342 patients (16.7% of overall number of the examinees and 34.6% of patients with acute GIH), According to EGDS, GIH was provoked by gastric lesions (68%), duodenal lesions (20%), gastroduodenal lesions (9%), esophageal erosions (3%). GIH was caused primarily by low-dose aspirin, indometacin, diclofenak and ibuprofen. Severe GIH occurred in 28.9% cases, moderate and mild ones in 20.8 and 50.3%, respectively. Conclusion. To reduce the incidence of GIH, it is necessary to take preventive measures against NSAId-gastropathies.