Gastropathy

Indomethacin was used traditionally, but its relative cyclooxygenase-1 (COX-1) selectivity theoretically increases its gastropathy risk. Thus other generic NSAIDs may be preferred. Adverse effects of NSAIDs include gastropathy (primarily peptic ulcers), renal dysfunction, and fluid retention. NSAIDs generally should be avoided in patients at risk for peptic ulcers, those taking warfarin, and those with renal insufficiency or uncontrolled hypertension or heart failure. 

Significant mortality is associated with NSAID gastropathy. G. Singh and G. Triadafilopoulos, Epidemiology of NSAID induced gastrointestinal complications, Journal of Rheumatology, 1999, 26, 56,18-24, by permission of Oxford University Press. 

Mikami, K., Otaka, M., Watanabe, D., Goto, T., Endoh, A., Miura, K., Ohshima, S., Yoneyama, K., Sato, M., Shibuya, T., Segawa, D., Kataoka, E., et al. (2006). Zinc L-carnosine protects against mucosal injury in portal hypertensive gastropathy through induction of heat shock protein 72. ]. Gastroenterol. Hepatol. 21,1669-1674. 

CNS Bowel Dysfunction Bladder Dysfunction Falls ET Other Gastropathy... 

It is indicated in gastroesophageal reflux disease and functional dyspepsia, diabetic gastropathy. 

Bruha R, Marecek Z, Spicak J, Hulek P, Lata J, Petrtyl J, Urbanek P, Taimr P, Volfova M, Dite P. Double-blind randomized, comparative multicenter study of the effect of terlipressin in the treatment of acute esophageal variceal and/or hypertensive gastropathy bleeding. Hepatogastroenterology 2002 49(46) 1161-6. 

Becker JC, Domschke W, Pohle T. Current approaches to prevent NSAID-induced gastropathy—COX selectivity and beyond. Br J Clin Pharmacol. 2004 58 587-600. 

Lazzaroni M, Bianchi Porro G. Non-steroidal anti-inflammatory drag gastropathy clinical results with H2 antagonists and proton pump inhibitors. ItalJ Gastroenterol Hepatol. 1999 31 (suppl 1) S73-S78. 

One of the major problems with use of NSAIDs in elderly patients, especially women, is the increased incidence of gastric mucosal damage (NSAID gastropathy). This condition can lead to significant GI bleeding and... 

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