ABSTRACT
This chapter reviews the comparative toxicity of ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal tract. Concern about the capacity of NSAIDs to cause damage to the upper gastrointestinal tract goes back to the 1930s and 1940s when the first associations between ingestion of aspirin and gastrointestinal bleeding were reported. NSAIDs may have local and systemic effects on the gastrointestinal mucosa. The former probably accounts for the widespread acute mucosal damage seen soon after ingestion. In relation to NSAIDs, the outcome of interest is significant ulceration and its complications, bleeding, perforation and stenosis. Stratified analyses were conducted in several studies to determine whether age modified the effects of NSAIDs. Drugs that appeared in two or more studies were included in the analysis to obtain a weighted summary order of the NSAIDs, according to relative risk.
