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Previous Volume 340:1888-1899 June 17, 1999 Number 24 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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One hundred years have passed since Felix Hoffman, working at Bayer Industries, reported the successful synthesis of acetylsalicylic acid as the first nonsteroidal antiinflammatory drug (NSAID).^1,2 At the suggestion of Hermann Dreser, Bayer's chief pharmacologist at the time,³ the compound was called "aspirin" and was purported to represent a convenient mechanism for the delivery of salicylic acid in the treatment of rheumatic diseases, menstrual pain, and fever.² Approximately 40 years elapsed before Douthwaite and Lintott⁴ provided endoscopic evidence that aspirin could cause gastric mucosal damage. Numerous reports have corroborated this observation,^5,6,7,8 and the introduction of more potent agents with an . . . [Full Text of this Article]

Epidemiology of Gastrointestinal Complications

Risk Factors for Gastrointestinal Complications

Pathogenesis of NSAID-Induced Gastroduodenal Mucosal Injury

Topical Injury

The Role of Prostaglandins

Clinical Spectrum of Injury

Treatment of NSAID-Related Dyspepsia

Histamine H₂–Receptor Antagonists

Proton-Pump Inhibitors

Management of NSAID-Related Gastroduodenal Ulcers

Mucosal Protective Agents

Antisecretory Drugs

Prevention of NSAID-Associated Gastroduodenal Ulcers

Concomitant Therapy

            Sucralfate

            H₂-Receptor Antagonists

            Proton-Pump Inhibitors

            Prostaglandins

Development of Safer NSAIDs

            Highly Selective Cyclooxygenase-2 Inhibitors

            NSAIDs Containing Nitric Oxide

            Other Approaches

Summary

Source Information

From the Section of Gastroenterology, Boston University School of Medicine and Boston Medical Center, Boston (M.M.W., D.R.L.); and the Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, Calif. (G.S.).

Address reprint requests to Dr. Wolfe at the Boston Medical Center, Section of Gastroenterology, 88 E. Newton St., Boston, MA 02118-2393, or at michael.wolfe@bmc.org.

References

Related Letters:

Gastrointestinal Toxicity of Nonsteroidal Antiinflammatory Drugs
Morgan R. W., Fries J. F., Harewood G., Wolfe M. M., Lichtenstein D. R., Singh G.
Extract | Full Text  
N Engl J Med 1999; 341:1397-1399, Oct 28, 1999. Correspondence

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