Gastritis describe any histologically confirmed inflammation of gastric mucosa.The patient suffers from burning abdomen pain, sometimes vomiting, frequently nausea etc.It has various etiology, the most common is association with H . Pylori infection. Other causes are autoimmune, reflux gastritis, stress induced and erosive gastritis.
Erosive gastritis
The latter is caused by agents that disturb the gastric mucosal barrier ; NSAIDS and alcohol are common causes. In this article we will be discussing the most common painkiller used i.e, NSAIDS how they cause gastritis.
NSAIDS and gastritis
The NSAIDS like diclofenac, ibuprofen cause gastric lesion which is due to the inhibition of cyclo oxygenase type 1 (COX -1) receptor enzyme. This reduces production of cytoprotective prostaglandins.
The solution
1)Using alternative painkiller in known patients or patients at risk of getting gastritis for treatment of other conditions like specific cox -2 inhibitors eg Celecoxib. Also paracetamol can be used which is mild on the stomach.
Change in lifestyle and diet which if not regulated can cause increase in severity.
How common is the condition? Have you seen any patient suffering from NSAIDS induced gastritis?
NSAID-induced gastritis is a common condition, especially among people who frequently use painkillers such as ibuprofen, naproxen, or aspirin. It occurs when these medications reduce the stomach’s protective lining, leading to irritation, inflammation, ulcers, or even bleeding in severe cases. The risk is higher with long-term use, high doses, older age, and a history of stomach ulcers. Symptoms may include abdominal pain, indigestion, nausea, and bloating, though some individuals remain symptom-free until complications develop.
People who take NSAID medicines every day often get stomach problems. This is called NSAID-induced gastritis. It can also hurt the lining of the part of the gastrointestinal tract. A lot of people who take these medicines get this problem. NSAID medicines can damage the stomach and the upper gastrointestinal tract. This is an issue, for people who take NSAID medicines regularly.
Many people don’t realize that over-the-counter NSAIDS can seriously irritate the stomach lining if used frequently. It is always wise to take NSAIDs with food, use the lowest effective dose and talk to a doctor about alternatives like acetaminophen or acid reducers if you have a sensitive stomach.
Very common in general practice. Issue is not when it is consumed on prescription. As physician will prescribe these drugs with antacids or for short periods with lowest possible dose or with food. Problem arises when nsaids are consumed as over the counter medicine for trivial aches and pains for longer duration without knowing the side effects.
These medicines should be used when there is definite indication
Great explanation! NSAIDs are among the most commonly used medications, so many people assume they’re completely harmless. It’s important to remind patients to avoid self-medicating for prolonged periods and to seek medical advice if pain persists. Using the lowest effective dose for the shortest duration can also help reduce the risk of NSAID-related gastric injury.
Yes, it is correct that painkillers are causing gastritis because it reduces production of prostaglandins from stomach and which is useful for stomach production. This leads to increase the acid secretion and causes diseases like peptic ulcer also.
We can reduce this condition by reducing pain killers or by using alternative treatment like celecoxib drugs which are mainly Cox 2 inhibitors. Or if it is impossible to give alternative drug we can start that patient by giving either H2RA or PPi’s.
Very common concern. Even one of my family member has suffered from this kind of situation. People use NSAIDS for pain then result in gastritis so they use PPI for gastritis. This becomes a vicious cycle and sometimes people land in renal failure
This was very informative. From what I understood, NSAIDs can cause gastritis by reducing the stomach’s protective mechanisms. I have also observed several cases of NSAID-induced gastritis during my hospital training. In many patients, PPIs are prescribed for gastric protection when NSAIDs are necessary. It reminds us that even commonly used medications should be used rationally and with proper precautions.
Very informative. I think many people take NSAIDs for headaches or body pain without realizing they can affect the stomach, especially with frequent or long-term use. Patient awareness is just as important as treatment.
Yes, using NSAIDs frequently for every other pain can surely lead patients to serious health-related complications. if they are taking them for stomach-related issues, they should manage their lifestyle and food choices to keep their gut healthy, or if they have recurrent gastric issues, they should get a consultation to treat the underlying cause.