Introduction: The anti-inflammatory drugs (NSAIDs) are among the drugs most prescribed and used worldwide. The frequency of complication associated with them, including upper gastrointestinal bleeding (UGB) is a source of high morbidity and mortality. The purpose of this study was to evaluate the epidemiological, endoscopic and evolutionary UGB associated with NSAIDs.
Materiel and methods: this is a descriptive and analytical study, first retrospective (January 2001-october 2006) and prospective (November 2006-October 2010) including all adults admitted for UGB, who received upper gastrointestinal endoscopy and taking NSAIDs.
Results: During the study period, 1635 patients were admitted for UGB which 271 (16.5%) had used NSAIDs. The mean age was 47.43 years ranging from 16 to 100 years. 69.3% of patients were under 60 years. A male was predominant (70%). Previous comorbidity were noted in 31% of cases, combination drug (steroid, anticoagulants and NSAIDs) in 9% of cases, and smoking in 19% of cases. NSAIDs implicated were aspirin (50.5%) and NSAIDs (37.6%). The bleeding was severe in 17.7% of cases. Specific endoscopic lesions (N=253) were bulbar ulcer (52.4%), gastric ulcer (18%) and erosive gastroduodenitis (22.8%). Medical treatment was instituted in all patients, endoscopic hemostasis in 2.6% of cases. An early rebleeding was noted in 7.3% of cases (N=20) and a death in 4.8% of cases (N=13).
Conclusion: The UGB associated with NSAIDs is frequent, affecting mainly young adults males. In 17.7% os cases, it is serious involving life threatening with mortality in 4.8%. Hence the value of a good prevention strategy in individuals at risk.