NSAID-INDUCED PATHOLOGY OF THE GASTROINTESTINAL TRACT: WHAT IS REMAINING IN THE SHADOW?
Since nonsteroidal anti-inflammatory drugs (NSAIDs) are effective preparations for the pathogenetic therapy of acute or chronic pain resulting from tissue damage and inflammation, the area for intended use of this class of drugs is quite wide. Therefore, practitioners have to face a frequent and serious problem such as NSAID-induced gastropathy, the clinical and pathogenetic features of which are well-understood and known. NSAIDs, however, are not only able to have a damaging effect in the gastroduodenal zone, but also cause damage to the mucous membrane of the esophagus, as well as the intestines. The infrequent compatibility of the clinical and endoscopic picture of NSAID-induced esophagitis, especially in elderly patients, the nonspecific symptomatology, as well as the difficulty of diagnosing small bowel lesions against the background of use of NSAIDs and acetylsalicylic acid (including its enteric-soluble forms), do not always allow the clinician to suspect this pathology. The lack of developed algorithms for the management of such patients also creates certain difficulties in correcting NSAID-induced lesions of the esophagus and intestines.