TY - JOUR T1 - Non-steroidal anti-inflammatory drugs and the gastrointestinal tract JF - Clinical Medicine JO - Clin Med SP - 131 LP - 134 DO - 10.7861/clinmed.2021-0039 VL - 21 IS - 2 AU - Foong Way David Tai AU - Mark E McAlindon Y1 - 2021/03/01 UR - http://www.rcpjournals.org/content/21/2/131.abstract N2 - 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. ER -