Endoscopy 2005; 37 - A29
DOI: 10.1055/s-2005-922891

Traditional anti-inflammatory and COXIB use in patients admitted urgently with gastrointestinal haemorrhage

R Naidoo 1, T Gilbert 1, J Woo 1, C Halling 1, M Cannon 1, A Gleeson 2, C Smyth 1, FE Murray 1
  • 1Department of Gastroenterology, Beaumont Hospital and Royal College of Surgeons of Ireland
  • 2Department of Accident and Emergency Medicine, Beaumont Hospital and Royal College of Surgeons of Ireland

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) cause peptic ulceration and ulcer complications. Their pattern of use has changed in recent years.

Aims: To determine the number of patients presenting to the Accident and Emergency department (A/E) with gastrointestinal haemorrhage (GIH), underlying aetiology, pattern of medication usage and awareness of side-effect profile.

Methods: Patients admitted through the A/E department with symptoms suggestive of GIH were prospectively identified over a 63-day study period. Clinical details and clinical in-hospital course was ascertained. Patients completed a questionnaire regarding medication and knowledge of side effects.

Results: 41 patients were admitted with GIH of whom 27(66%) were anaemic and 21(45%) had evidence of haemodynamic instability. 25(56%) patients required blood transfusions. 34(83%) patients had abnormal findings on upper and/or lower endoscopy. 30(73%) of these patients were taking regular traditional NSAIDs +/- aspirin, of whom 3 were also taking coxibs. 10 patients had a history of PUD and only 2 of these patients were taking proton pump inhibitors (PPI). 17(57%) of these patients were unaware of potential gastrointestinal side effects related to their current medication.

Conclusions: Traditional NSAIDs remain a significant cause of GIH in patients admitted via the A/E department. Stratagies to reduce complications were infrequently utilised.