Review article: non-steroidal anti-inflammatory drugs and Helicobacter pylori

Non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori are well-recognized causes of gastroduodenal mucosal damage. This damage is med iated through the effects of both agents on acid secretion, neutrophil acti vity and function, and prostaglandin metabolism. Clinical trials on the int errelationship between H. pylori, NSAIDs and gastroduodenal mucosal injury have yielded conflicting results. No consensus has been reached on what rec ommendations should be implemented with regard to H. pylori eradication in patients on long-term NSAID therapy. At present, the presence of H. pylori is identified at endoscopy and eradication is carried out in symptomatic pa tients. Asymptomatic patients remain a dilemma that requires further invest igation. Clinical practice will continue to be tailored to a patient's indi vidual requirements. Therefore, in patients at risk of gastrointestinal hae morrhage, and on NSAID therapy, acid suppression therapy should be prescrib ed.