Upper gastrointestinal lesions in elderly patients presenting for endoscopy: relevance of NSAID usage

• Published in: The American journal of gastroenterology Vol. 86; no. 8; p. 961
• Main Authors: Bellary, S V, Isaacs, P E, Lee, F I
• Format: Journal Article
• Language: English
• Published: United States 01.08.1991
• Subjects: Aged; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Duodenal Ulcer - chemically induced; Duodenal Ulcer - diagnosis; Endoscopy, Digestive System; Esophagitis - chemically induced; Esophagitis - diagnosis; Female; Gastritis - chemically induced; Gastritis - diagnosis; Gastrointestinal Diseases - chemically induced; Gastrointestinal Diseases - diagnosis; Humans; Male; Prospective Studies; Stomach Ulcer - chemically induced; Stomach Ulcer - diagnosis
• ISSN: 0002-9270
• DOI: 10.1111/j.1572-0241.1991.tb07196.x

The occurrence of upper gastrointestinal disease and the relevance of nonsteroidal antiinflammatory drug (NSAID) usage were documented in 511 consecutive patients (321 women, 190 men) over 70 yr old, referred for upper gastrointestinal endoscopy in a district general hospital. The findings were benign esophageal disease (43%), normal (15%), gastric ulcer (11.5%), and duodenal ulcer (11%). Gastric ulcers were more common in women taking NSAIDs (25%) than in NSAID abstainers (7%) p less than 0.001 and male NSAID users (8%) p less than 0.001. Esophagitis and esophageal stricture were not influenced by NSAID usage, but gastric erosions were more common (10% vs. 3%) p less than 0.01. Of 142 patients receiving NSAIDs, 41% presented with hemorrhage, compared with 20.5% of NSAID abstainers (p less than 0.001). Hemorrhage was as common in aspirin takers (15 of 33, 45%) as in standard-dose NANSAID takers (43 of 109, 39%), even though 86% were taking 300 mg of aspirin per day or less. In elderly patients, esophageal disease is common. NSAID use, even low-dose aspirin, is associated with an increased risk of hemorrhage. In females, NSAID usage is associated with gastric ulcer.