Approaches to healing and prophylaxis of nonsteroidal anti-inflammatory drug–associated ulcers

Treating and preventing peptic ulcers associated with nonsteroidal anti-inflammatory drugs (NSAIDs) calls for clinical judgment. Physicians must weigh their patients’ need for anti-inflammatory therapy against their individual risks for ulcer development; their likelihood of coping with an ulcer complication if it should develop; and the economics, efficacy, and tolerability of various treatment and prevention options. This article considers some general strategies common to both treatment and prevention. Data from randomized trials that can guide clinicians and their patients as they attempt to heal an established NSAID ulcer or prevent one occurring in the future are also reviewed.