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Canadian Journal of Gastroenterology
Volume 4, Issue 3, Pages 91-94

The Assessment of Evidence Associating Nonsteroidal Anti-Inflammatory Drugs with Complications of Peptic Ulcerations

MJS Langman

Department of Medicine, Queen Elizabeth Hospital, Birmingham, UK

Copyright © 1990 Canadian Association of Gastroenterology. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution, and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


A causal relationship is now firmly established between nonsteroidal anti-inflammatory drug (NSAlD) use and the occurrence of peptic ulcer complications. In the United Kingdom, rising NSAID use has been matched by rises in ulcer mortality and perforation rates, particularly in older women. It is not likely, however, that drug use accounts for the entire increase. The reasons why some people develop ulcer complications and others do not are poorly understood. It is plausible to propose that other factors, such as history of ulcer or indigestion, current smoking, and alcohol consumption, might raise this risk; however, supportive evidence is lacking.