Gastrointestinal Complications Associated With Non-steroidal Anti-inflammatory Drug Use Among Adults: A Retrospective, Single-Center Study

Nouf Alhammadi; Abdullah H Asiri; Fatimah M Alshahrani; Alhanouf Y Alqahtani; Maraam M Al Qout; Raad A Alnami; Ahlam S Alasiri; Ahmed S Al-Zomia

doi:10.7759/cureus.26154

Gastrointestinal Complications Associated With Non-steroidal Anti-inflammatory Drug Use Among Adults: A Retrospective, Single-Center Study

Cureus. 2022 Jun 21;14(6):e26154. doi: 10.7759/cureus.26154. eCollection 2022 Jun.

Authors

Nouf Alhammadi¹, Abdullah H Asiri², Fatimah M Alshahrani², Alhanouf Y Alqahtani², Maraam M Al Qout³, Raad A Alnami², Ahlam S Alasiri³, Ahmed S Al-Zomia²

Affiliations

¹ Internal Medicine, King Khalid University, Abha, SAU.
² Medicine and Surgery, King Khalid University, Abha, SAU.
³ College of Medicine, King Khalid University, Abha, SAU.

Abstract

Background Traditional non-steroidal anti-inflammatory drugs (NSAIDs) are recognized to injure the upper gastrointestinal tract (GIT) mucosa. For example, gastric mucosal hemorrhages can be caused by a single dose of 650 mg of aspirin. Nearly 30% to 50% of NSAID users showed endoscopic lesions including subepithelial hemorrhages, erosions, and ulcerations. These lesions are often asymptomatic and are mostly found in the gastric antrum. With the chronic exposure, the mucosa adapts to the aggression of the NSAIDs, whereby these lesions slowly lessen or fade. Aim The aim of this study is to detect the association between NSAIDs and gastrointestinal complications among the general population in the Aseer region, Saudi Arabia. Methodology A record-based retrospective study was conducted targeting people with GIT complications who were 20 years old and above. We reviewed patients' records from the GIT clinic in the Aseer region of Saudi Arabia. We reviewed specifically patients who had GIT complications like gastritis, abdominal pain, GIT bleeding, heartburn, nausea, vomiting, peptic ulcer, and diarrhea. Then we contacted those patients individually to fill out a questionnaire. Participants less than 18 years, those who refused to complete the questionnaire, or any patients with no history of GIT complications were excluded. An online questionnaire was sent to the patients with GIT complications. The questionnaire included participant's personal data, NSAID use, and associated GIT complications. The questionnaire was uploaded online using social media platforms by the researchers and their relatives and friends during the period from March 2012 to May 2022. Results A total of 211 participants with GIT complications completed the study questionnaire. Participant ages ranged from 20-59 years with a mean age of 31.2 ± 12.9 years old. A total of 140 (66.4%) were males and 175 (82.9%) were from urban areas. A total of 156 (73.9%) were non-smokers. A total of 103 (48.8%) participants used NSAIDs. As for complications, the most reported were peptic ulcer (37.9%), GIT bleeding (5.8%), GIT erosions (4.9%), and intestinal obstruction (3.9%) while 59.2% had no complications. Conclusions The current study revealed that nearly one out of every two participants in the Aseer region mainly used NSAIDs as tablets for pain. Regarding high utilization rates, less than half of them developed GIT complications, mainly peptic ulcers.

Keywords: gastric mucosal hemorrhages; gastrointestinal complications; git complications; injury git mucosa; nsaid; population; risk factors; saudi arabia; steroid use.