Digestive Diseases and Sciences

, Volume 42, Issue 5, pp 990–997

Nonsteroidal Antiinflammatory Drugs Are Associated with Both Upper and Lower Gastrointestinal Bleeding

  • C. Mel Wilcox
  • Lorraine N. Alexander
  • George A. Cotsonis
  • W. Scott Clark
Article

Abstract

To evaluate the association between nonsteroidalantiinflammatory drug (NSAID) use and uppergastrointestinal bleeding (UGIB) and lowergastrointestinal bleeding (LGIB), we performed aprospective case-control study at a large inner-cityhospital over a 28-month period evaluating 461consecutive patients hospitalized for UGIB and 105 withLGIB. During the same period, 1895 in-patients evaluatedby our gastroenterology consultative service served ascontrols. At the time of initial evaluation, allpatients were asked about the use of any prescription orover-the-counter NSAID product within one week of admission. Endoscopic examination was performedin most patients with bleeding. NSAID use was almostequivalent in patients with UGIB and LGIB (60%) andsignificantly greater than controls [34%; P < 0.001; odds ratio (OR) 3.0; 95% CI, 2.4-3.6]. The age,race, and gender adjusted risk for LGIB associated withNSAID use was significant [adjusted OR (AOR) 2.6; 95% CI1.7-3.9], although less than UGIB (AOR 3.2; P = 0.34). The risk associated withdiverticular bleeding (N = 53, AOR 3.4; 95% CI 1.9-6.2)was higher than duodenal ulcer bleeding although notsignificantly (N = 97, AOR 3.0). We conclude that NSAIDuse is strongly associated with LGIB and from lesionsnot considered associated with mucosal ulceration suchas diverticulosis.

BLEEDING HEMORRHAGE NONSTEROIDAL ANTIINFLAMMATORY DRUGS ASPIRIN DIVERTICULOSIS 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Plenum Publishing Corporation 1997

Authors and Affiliations

  • C. Mel Wilcox
  • Lorraine N. Alexander
  • George A. Cotsonis
  • W. Scott Clark

There are no affiliations available

Personalised recommendations