RT Journal Article SR Electronic T1 Non-steroidal anti-inflammatory drugs and the gastrointestinal tract JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 131 OP 134 DO 10.7861/clinmed.2021-0039 VO 21 IS 2 A1 Foong Way David Tai A1 Mark E McAlindon YR 2021 UL http://www.rcpjournals.org/content/21/2/131.abstract AB Non-steroidal anti-inflammatory drugs (NSAIDs) are used commonly but can cause foregut symptoms, peptic ulcer disease and small bowel enteropathy. Such iatrogenic injury can be complicated by gastrointestinal bleeding and perforation. Limiting NSAID use or co-administration with proton pump inhibitors (PPIs) reduce dyspepsia, peptic ulcer disease and rates of complications. Selective cyclo-oxygenase (COX)-2 inhibitors are as effective as adding PPIs in preventing upper and lower gastrointestinal complications. COX-2 inhibitors are suggested in those with high cardiovascular risk and the addition of PPI in those with high risk of bleeding. Where required, COX-2 inhibitor monotherapy may be preferred in unexplained iron deficiency anaemia.