Current Gastroenterology Reports

, Volume 6, Issue 6, pp 447–453

Is no NSAID a good NSAID? approaches to NSAID-associated upper gastrointestinal disease

  • Stephen Y. Chang
  • Colin W. Howden


Upper gastrointestinal disease induced by use of nonsteroidal anti-inflammatory drugs (NSAIDs) remains a major problem that affects a broad segment of the population, given the frequent use of these drugs by prescription and over the counter. The emergence of the cyclooxygenase (COX)-2 selective inhibitors (coxibs) has introduced a new option that may result in less upper gastrointestinal disease. Recent large studies have demonstrated this advantage, with the caveat that concurrent use of low-dose aspirin may mitigate this benefit. Unfortunately, the relatively high cost of the coxibs makes them not cost-effective unless confined to certain higher-risk populations. Finally, even newer versions of NSAIDs, such as nitric oxide (NO)-releasing aspirin and the COX-inhibiting NO donors, are potential alternatives to traditional NSAIDs with less upper gastrointestinal toxicity.


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Copyright information

© Current Science Inc 2004

Authors and Affiliations

  • Stephen Y. Chang
    • 1
  • Colin W. Howden
    • 1
  1. 1.Division of GastroenterologyNorthwestern University Feinberg School of MedicineChicagoUSA

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