Use of NSAIDs. An assault on the upper gastrointestinal tract.

Nonsteroidal anti-inflammatory drugs (NSAIDs) often cause gastric and, to a lesser extent, duodenal injury. Patient care can be improved if physicians are familiar with the risk factors and have a good understanding of (1) the actions of various NSAIDs, (2) mucosal protection strategies, and (3) options for treatment of damage once it occurs. It is hoped that with careful selection of an NSAID and use of cytoprotective agents, treatment of these injuries will be necessary less often in the future.