Asymptomatic and symptomatic gastroduodenal patients affected by rheumatic disease treated with non-steroidal anti-inflammatory drugs

It is becoming more apparent that the common gastritis and ulcer complications associated with non steroidal anti-inflammatory drugs (NSAID's) are distinct from classic peptic ulcer disease. To assess the incidence of gastrointestinal lesions and the existence of correlation with gastrointestinal symptoms, patients affected by rheumatic diseases treated with NSAIDs were carefully questioned to evaluate gastrointestinal symptoms and then underwent an esophagogastroduodenoscopic examination. The study demonstrates a relevant absence of gastrointestinal symptoms with an high incidence of gastric mucosal lesions in this patients. Asymptomatic lesions seem to be a characteristic feature of NSAID gastropathy. The blockade of synthesis of prostaglandins, due to the inhibition of cyclooxygenase by NSAIDs, may create an environment conducive to gastritis or ulcer disease and may be responsible of the absence of gastrointestinal symptoms.