THE MANAGEMENT OF NONSTEROIDAL ANTIINFLAMMATORY DRUG-INDUCED GASTRODUODENAL ULCERS

The risks associated with NSAID-induced gastroduodenal lesions are now relatively well defined. Identification of high-risk patients is important for prophylactic treatment or for maintenance treatment with gastric acid-suppressing medication during NSAID therapy. If patients develop a gastric ulcer and continue to take NSAIDs, all available evidence suggests that strong acid-suppressing therapy is important. Good healing rates have been described with conventional doses of H-2 antagonists, but studies with higher doses have to be awaited. Small prepyloric or antrum ulcers will probably react well to conventional H-2 antagonists; larger crater-like ulcers are probably best treated with omeprazole. When patients develop a duodenal ulcer and continue to take NSAIDs, all available evidence suggests that excellent treatment results can be obtained with conventional doses of H-2 antagonists.