PMID: 10192617

Issn Print: 0192-0790

Publication Date: 1999/04/01


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Nonsteroidal Anti-Inflammatory Drugs and Gastric Mucosal Blood Flow

M. Guslandi; L. Foppa; L. Fanti; M. Sorghi

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Excerpt

Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to exert damaging effects on the gastric mucosa, promoting development of mucosal erosions and/or ulcerations.1 The mechanisms responsible for NSAID gastropathy involve both topical irritation by direct contact with the gastric mucosa and systemic effects due to inhibition of prostaglandin synthesis through blockade of gastric cyclooxygenase-1. Gastric prostaglandins protect the mucosa by stimulating defensive factors such as mucus production, bicarbonate secretion, and gastric microcirculation.2
Gastric mucosal blood flow provides mucosal protection against aggressive factors by supplying oxygen and nutrients and by removing into the general circulation back-diffused hydrogen ions deriving from HCl present in the gastric juice.3 A reduced blood supply leads to mucosal ischemia that promotes mucosal damage, whereas an efficient local microcirculation prevents gastric injury and stimulates tissue repair.3,4
Animal studies have shown that NSAIDs can actually reduce gastric blood flow,3,4 but little is known about the effect of those drugs on gastric microcirculation in humans.
The aim of the present study was to investigate the state of gastric mucosal perfusion in patients taking NSAIDs.
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