Non-steroidal anti-inflammatory drugs: how do they damage the gut?

Br J Rheumatol. 1994 Jul;33(7):605-12. doi: 10.1093/rheumatology/33.7.605.


NSAIDs are widely prescribed for the treatment of musculoskeletal disorders. The gastrointestinal tract, predominantly the stomach, bears the brunt of their side-effects. The basis of this toxicity is certainly multifactorial, with a wide range of local effects and mucosal defences being implicated. This review will highlight: (1) the epidemiology of NSAID-induced gastrointestinal toxicity; (2) their effects on prostaglandins, and the phenomenon of cytoprotection; (3) effects on neutrophil function; (4) effects on mucosal blood flow; (5) responses of the mucosa to damage (restitution, adaptation, and regenerative repair); (6) the relevance of growth factors; (7) interactions with Helicobacter pylori in ulcerogenesis, and finally (8) the effects of NSAIDs on the small intestine and colon.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Digestive System / drug effects*
  • Digestive System / pathology
  • Gastrointestinal Diseases / chemically induced
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / pathology
  • Humans
  • Musculoskeletal Diseases / drug therapy


  • Anti-Inflammatory Agents, Non-Steroidal