Frequency of NSAID induced peptic ulcer disease.

OBJECTIVE To determine the frequency of peptic ulcer disease in patients on nonsteroidal anti-inflammatory drugs (NSAID). METHODS Record of eight hundred and twenty consecutive patients undergoing upper gastrointestinal (GI) endoscopy; from January 1998 to December 2000 were reviewed. The endoscopic diagnosis varied from gastritis, peptic ulcer to duodenitis. The use of NSAID was documented by reviewing medical records of patients with peptic ulcer. RESULTS Peptic ulcers were found in 43% (353/820) patients. NSAID associated peptic ulcers were identified in 14.7% (52/353) patients. Diclofenac and aspirin were most common NSAIDs associated with peptic ulcers in 32.7% (17/52) and 30.7% (16/52) patients, respectively. Duodenal ulcer was more common than gastric ulcer 65.3% (34/52) and 42.3% (22/52), respectively. H. pylori infection was present in 46% (24/52) of the cases. NSAIDs treatment and / or H. pylori infection compared to non NSAIDs and non H. pylori infected peptic ulcer disease were significantly associated with gastric ulcer (p = 0.004) and duodenal ulcer (p = 0.009) respectively. CONCLUSION NSAID-associated peptic ulcer disease is common in Pakistan and most frequently associated with gastric and duodenal ulcer. H. pylori infection is common in association with NSAID related peptic ulcers.