NONVARICEAL UPPER GASTROINTESTINAL-BLEEDING INDUCED BY ASPIRIN AND NONSTEROIDAL ANTI INFLAMMATORY DRUGS

The use of non-steroidal anti inflammatory drugs is known to increase the risk of upper gastrointestinal bleeding. Objectives: We carried ou t a retrospective study to look at the use of aspirin and non-aspirin NSAIDs in the patients who presented to Riyadh Armed Forces Hospital w ith upper gastrointestinal bleeding. Patients: During the period 1st J anuary, 1980 - 1st June, 1994. Five hundred and seventy-nine patients presented with non-variceal upper gastrointestinal bleeding at the Gas troenterology Department. Results: One hundred and ninety-eight of the se 579 patients had bleeding due to aspirin or NSAID. 16.6% of these p atients used aspirin and 18.13% used non aspirin NSAIDs. Forty-five po int sixteen percent of the patients who used aspirin were 60 years of age or older and 58.9% of those who used non aspirin NSAIDs were 60 ye ars or over. In both groups there were more males than females (82.02% in the aspirin users and 68.6% in the non aspirin NSAIDs users). Gast ric erosions were the commonest findings 35% in both groups). In 80% o f the patients non aspirin NSAIDs were used for non specific musculosk eletal pains. Conclusions: Simple analgesics should be tried first wit h other supportive measures such as physiotherapy. When needed NSAIDs should be used cautiously especially in elderly patients and should be used in small doses and avoided in patients with history of peptic ul cer disease to avoid upper gastrointestinal bleeding and other complic ations.