The nonsteroidal anti-inflammatory drugs controversy

What is the interaction between Helicobacter pylori and nonsteroidal anti-inflammatory drugs (NSAIDs) in the pathogenesis of peptic ulcer? The data are often conflicting, and further studies clearly are needed to clarify some important areas of uncertainty. Far from being at increased risk for ulcers and their complications when both factors are present, however, there is evidence that in some patients the risk is somewhat reduced-especially in the stomach and especially if the patient also is taking an antisecretory drug to reduce the NSAID-ulcer risk. The mechanism of the protective effect is not certain, but some candidate mechanisms are discussed.