Abstract:
Background. Long-term administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
is one of the most frequent medication-related causes of upper gastrointestinal pathology,
with a significant impact on population health and on emergency medical services,
increasing their burden in the last 10 years.
Objective(s). The aim of this paper is to highlight the correlation between prolonged NSAID
use, the onset of gastrointestinal emergencies, by analyzing frequency, underlying
mechanisms, and clinical implications.
Materials and methods. A systematic review of the scientific literature was conducted
using the PubMed, Web of Science, Scopus, UpToDate, and Google Scholar databases,
covering the period from January 2020 to May 2025.Original studies and reviews were
included based on the
Keywords: "NSAIDs", "upper gastrointestinal emergencies", "upper gastrointestinal
bleeding (UGIB)".
Results. The literature review reveals that over 30% of upper gastrointestinal bleeding
(UGIB) cases presenting to emergency departments are associated with NSAID use.
Mortality among these patients, particularly the elderly or those with comorbidities, is
estimated to range between 6–10%. Approximately 25–30% of chronic NSAID users develop
mucosal lesions, and 15–20% develop peptic ulcers. The annual incidence of complicated
ulcers (e.g., bleeding, perforation) is estimated at 0.8–2.0%. These complications often
require endoscopic or surgical intervention, significantly increasing both morbidity and
hospital stay duration.
Conclusion(s). Long-term use of NSAIDs represents a major risk factor for upper
gastrointestinal emergencies, particularly bleeding and complicated ulcers. Identifying
vulnerable patients and ensuring careful monitoring can significantly reduce associated
morbidity and mortality across worldwide.
