Many NSAID users who bleed don't know when to stop

Upper gastrointestinal bleeding and perforation are common and serious adverse effects of non-steroidal anti-inflammatory drugs. About a third of all ulcer bleeding in older people is associated with these drugs1 2; the same may apply to perforation. The most important predisposing influences are the type and dose of drug (and use of two non-steroidal anti-inflammatory agents together), which can increase the risk up to 20-fold. Other risk factors include prior ulcer,3 anticoagulants, systemic corticosteroids,4 smoking,5 alcohol consumption,6 and old age.1 3 Some of these are independent, so that treatment with non-steroidal anti-inflammatory drugs increases an already high risk. As we look for ways of lowering the risk of bleeding in patients using non-steroid anti-inflammatory drugs, an ingenious investigation from Newcastle offers a new lead.6

Wynne and Long studied 50 consecutive patients admitted to hospital with an acute gastrointestinal bleed who had taken any of four commonly used non-steroidal anti-inflammatory drugs in the preceding three days …