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Nonsteroidal antiinflammatory drugs (NSAIDs) increase the risk of upper gastrointestinal bleeding. This multicenter case-control study from Spain provides new data on the magnitude of that risk. The authors asked hospitalized patients (875 with bleeding ulcers or erosions of the stomach or duodenum, and 2682 age- and sex-matched controls without upper GI bleeding) about recent use of nonnarcotic analgesics and NSAIDs.
Four NSAIDs commonly used by these subjects (indomethacin, naproxen, diclofenac, and piroxicam) markedly increased the risk of bleeding: odds ratios ranged from 4.9 to 19.1 for subjects who used the drug at least once during the week before symptoms began. Aspirin was also associated with a substantially increased risk of bleed…