Pathologies digestives hautes associées aux anti-inflammatoires non stéroïdiens

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Résumé

assess the pathology of the upper digestive tract associated with NSAIDs. it is a prospective study from June 2012 to July 2014 including, patients under treatment with nonsteroidal anti-inflammatory drug. They were seen in consultation for gastrointestinal symptoms (abdominal pain, dyspepsia, hematemesis, melena, vomiting), and had undergone upper endoscopy. NSAIDs were considered as the cause of endoscopic lesions if taken during the preceding two weeks. Gastric biopsy in search of Helicobacter pylori was not systematic. A total of 142 patients were recruited, among them 72 men (50.7%). The average age was 48.8 years. There were 45 patients with hypertension (31.7%), and 11with valvular disease (7.7%). Twenty-six patients had rheumatic disease, or 16.2%. NSAID use was resulting from self-medication in 34% of cases. Ibuprofen was the most antiinflammatory used (50%). The most frequent indication for endoscopy was epigastric pain (64%), followed by hematemesis and / or melena (29.6 %). The duration of NSAID use was more than 12 months in 29 patients (20.4%), between one and three months for 27 patients (19%) and one to 14 days in 52 patients (36.6%). Peptic ulcer disease was observed in 61 patients (42.9%). Twenty-six patients (18.3%) were taking two NSAIDs and 14 of them had a peptic ulcer (53.8%). The acid acetyl salicylic low dose (<300 mg) was used in 26 patients (18.3%), of which 12 presented a peptic ulcer (46.1%) and three gastrointestinal bleeding (11.5%). Dyspepsia was observed in 18 patients (12.7%). The risk of peptic ulcer was associated with male gender (OR = 1.4 95% CI: 0.7 to 2.7), more than 12 months NSAID taking (OR = 4.9 95% CI 1.3 to 10.9).

Mots-clés

Medicine, Gastroenterology