Gastro-injuring drugs - Drugs that cause gastritis and peptic ulcer

Gastrologic drugs are potentially capable of generating inflammatory processes affecting the gastric mucosa (gastritis), up to causing real erosions and acute ulcerations. If used by subjects already suffering from these diseases, gastric injurious drugs increase the risk of bleeding and perforation from peptic ulcer, slowing down healing and reducing the therapeutic efficacy of gastroprotective drugs.

All patients suffering from gastritis or peptic ulcer should therefore avoid the intake of gastrically damaging drugs; even in the healthy population, particular caution is still required in the continuous use of these drugs, possibly resorting to buffered forms and alternative medicines (eg selective inhibitors of the COX-2 instead of traditional NSAIDs), or by combining gastroprotectors such as Misoprostol, Omeprazole and Lansoprazole. It would also be advisable to reduce the consumption of alcohol and cigarette smoking in subjects receiving gastric-injuring drugs, as they are important risk factors for gastritis and peptic ulcer, and enhancing the gastric-injuring of these drugs; in this regard, see the rules for proper food hygiene in the course of gastritis.

Main gastrointestinal drugs:

• Non-steroidal anti-inflammatory drugs (NSAIDs), which also includes the famous aspirin (acetylsalicylic acid): these are the gastrically damaging drugs par excellence, given the large presence in numerous over-the-counter (OTC) medicines. decreasing order of gastric injuries: Ketorolac (the most gastrically injurious), Piroxicam, Indomethacin, Ketoprofen, Naproxene, Diflunisal, Sulindac, Nimesulide, Ibuprofen, Diclofenac and Paracetamol (the least gastric injurious, but toxic to the liver at high doses). more NSAIDs, unless directly prescribed by a doctor, is contraindicated as it increases the risk of gastric injury.
• Steroidal anti-inflammatory drugs (cortisones):
• Anticoagulant drugs (low-dose acetylsalicylic acid, heparin, warfarin) increase the risk of bleeding from existing ulcers; Before using these drugs, the subjective risk should therefore be assessed based on age, concomitant diseases, history of peptic ulcer, previous episodes of gastrointestinal bleeding, concomitant use of NSAIDs or aspirin, and duration and intensity of anticoagulant treatment.
• Antiblastic (anticancer) drugs.
• Serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine; they enhance the gastric injuries of NSAIDs.

Medicinal herbs that can increase the gastric damage of the drugs mentioned, in particular NSAIDs: angelica, dandelion, bitter orange peel, anise, star anise, devil's claw, Roman chamomile, cinnamon, artichoke, centaurea minor, ivy, gentian, guaiac, clover fibrin.

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