The incidence of Non Steroidal Anti-Inflammatory drugs as a causative agent of peptic ulcer diseases.

Abstract

Non steroidal anti-inflammatory drugs(NSAIDs) it is anti-inflammatory drugs .Many people take an anti- inflammatory drug for arthritis, muscular pains & to protect against blood clots form. These drugs sometimes affect the mucus barrier of the stomach and allow acid to cause an ulcer. About 2 in 10 stomach ulcers are caused by anti- inflammatory drugs. The discovery that the primary mechanism behind NSAID-associated upper GI side-effects was through systemic inhibition of COX-1-mediated prostaglandin synthesis in the gastric mucos.  COX-2 selective NSAIDs, continues to carry significant risk of injury to the gastro-duodenal mucosa possibly because COX-2 selective NSAIDs are not totally COX-2 specific, but also inhibit COX-1 to a certain degree. Acidic NSAIDs, including aspirin, may also have a topical irritant effect on the gastric mucosa. Indeed, there is evidence of significant localized foci and damaged cells only 16 minutes after administration of aspirin. Patients & methods.A three hundred-forty four  patient including by this study all of them complaining of signs symptoms of peptic ulcer & the diagnosis confirm by endoscopy examination .Results:- A 170(49.4%) patients with gastric ulcer & 174(50.6%) patients with duodenal ulcer. A gastric ulcer patients. A forty seven (27.65%) patients were consider as NSAIDs users .the duration of using NSAIDs was divided  into acute(less than 3 months) & chronic  states so 28(59.6)% was acute user while 19(40.4)% was chronic user .A duodenal  ulcer patients . A twenty-two (12.7%) patients were consider as NSAIDs users .the duration of using NSAIDs was divided  into acute & chronic  states so 12(54.5)% was acute user while 10(45.5)%was chronic user . A significant difference was detected between gastric ulcer & duodenal ulcer which indicate that NSAIDs mostly cause gastric ulcer than duodenal ulcer & this is due to the fact that these agents affecting the defense mechanism of gastric mucosa in both topical & systemic administration. Conclusion:-A high causing rate of NSAIDs in  inducing  peptic  ulcer  .Reducing  the  administration  of  analgesia  as  possible  as  &  to  be  limiting  to  really indication .It is better to used anti-ulcer agent in combine with the NSAIDs agents especially in long term therapy .