H: Peptic ulcer and non-steroidal anti-inflammatory agents

SUMMARY Aspirin is generally regarded as a cause of gastric ulcer but the role of non-steroidal anti-inflammatory agents and paracetamol in the aetiology of peptic ulcer is unclear. To investigate this ' we conducted a case control study of 180 matched pairs of peptic ulcer patients and controls obtained from surgical and dermatology outpatient clinics. There were 95 gastric ulcer and 85 duodenal ulcer patients. A statistically and clinically significant association (relative risk=5) was found between the regular use of non-steroidal anti-inflammatory agents and gastric ulcer. There was also evidence of positive associations between gastric ulcer and aspirin containing preparations with or without non-steroidal anti-inflammatory agents. By contrast, duodenal ulcer was unrelated to these drugs. Too few patients used paracetamol for any conclusion to be drawn on its role. Although aspirin use is widely regarded as related to chronic gastric ulcer, ' the role of the non-steroidal anti-inflammatory agents (NSAIA) and para-cetamol in peptic ulcer, particularly duodenal ulcer, is unclear.26 Recent studies have shown an associa-tion of fastric ulcer with aspirin and the other NSAIAs and of perforated ulcer, both duodenal and gastric, with aspirin and the NSAIAs. " To clarify this issue we conducted a case control study of gastric ulcer and duodenal ulcer patients and controls, comparing their consumption of these drugs