Pathogenesis of nonsteroidal anti-inflammatory drug gastropathy: Clues to preventative therapy

Salim M.A. Bastaki, John L. Wallace

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Gastric ulceration and bleeding are major impediments to the chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs). The development of effective therapies for prevention of these adverse effects requires better understanding of their pathogenesis. Several features of NSAIDs contribute to the development of damage in the stomach, including the topical irritant effects of these drugs on the epithelium, impairment of the barrier properties of the mucosa, suppression of gastric prostaglandin synthesis, reduction of gastric mucosal blood flow and interference with the repair of superficial injury. The presence of acid in the lumen of the stomach also contributes to the pathogenesis of NSAID-induced ulcers and bleeding in a number of ways. Acid impairs the restitution process, interferes with hemostasis and can inactivate several growth factors that are important in mucosal integrity and repair. Profound suppression of gastric acid secretion has been shown to be effective in preventing NSAID induced ulceration. There is a strong possibility that new NSAIDs entering the market will have greatly reduced toxicity in the gastrointestinal tract.

Original languageEnglish
Pages (from-to)123-127
Number of pages5
JournalCanadian Journal of Gastroenterology
Issue number2
Publication statusPublished - Mar 1999
Externally publishedYes


  • Acid secretion
  • H receptor antagonists
  • Nonsteroidal anti-inflammatory drugs
  • Proton pump inhibitors
  • Ulcer

ASJC Scopus subject areas

  • Gastroenterology


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