THE OUTCOME OF PEPTIC-ULCER HEMORRHAGE IN RELATION TO CONSUMPTION OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS OR ASPIRIN

Aim: To compare the outcome of 76 patients who presented with severe peptic ulcer haemorrhage whilst taking nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin with that of 112 patients who were not taking these drugs and who developed peptic ulcer haemorrhage over the same time period. Methods: The two groups of patients were managed identically and endoscopic therapy was attempted in all cases. Results: The group taking NSAIDs or aspirin tended to be older and had a higher prevalence of cardiorespiratory disease. The severity of bleeding (as assessed by the presence of shock, anaemia and endoscopic stigmata) was similar in the two groups. Outcome in terms of uncontrolled haemorrhage, rebleeding and blood transfusion requirements did not differ significantly in the two groups. The NSAID group had a significantly longer duration of admission, almost certainly attributable to a higher prevalence of co-morbid diseases. Conclusions: Despite the deleterious effects of NSAIDs and aspirin upon renal and platelet function, the prognosis of peptic ulcer bleeding is not adversely affected by NSAID or aspirin therapy.