Indigestion and non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are usually thought to pose a dilemma for doctors wishing to prescribe them. Their anti-inflammatory and analgesic properties have led to their widespread use for rheumatoid and (much more commonly) other conditions often regarded as more trivial. However they are ulcerogenic to the stomach and duodenum and lead to a threefold to 10-fold increase in ulcer complications, hospitalisation, and death from ulcer disease.¹

In fact, the dilemma is more complex than whether potentially life threatening drugs should be used to manage conditions that are uncomfortable but not in themselves life threatening. There is growing evidence that NSAIDs have other incidental benefits. The only study to investigate overall life expectancy with drug use found non-significant trends towards enhanced rather than reduced life expectancy. Aspirin has benefits in preventing cardiovascular disease and probably cancer that seem to far outweigh the hazards of gastrointestinal ulceration. Limited evidence suggests that these benefits may be shared by other NSAIDs.