ASSESSING GASTRIC MUCOSAL CHANGES IN CHRONIC NSAID USERS WITH AND WITHOUT GASTROPROTECTIVE THERAPY IN COMPARISON: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/m2dfp028Keywords:
Anti-Inflammatory Agents, Non-Steroidal, Endoscopy, Gastrointestinal, Gastric Mucosa, Gastrointestinal Diseases, Helicobacter Infections, Proton Pump Inhibitors, Risk FactorsAbstract
Background: Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a major cause of gastric mucosal injury, ranging from gastritis to peptic ulcer disease. Gastroprotective agents such as proton pump inhibitors are widely prescribed to reduce these risks, yet their real-world effectiveness in preserving gastric mucosal integrity remains underexplored, particularly in South Asian populations.
Objective: To evaluate gastric mucosal changes among chronic NSAID users receiving and not receiving gastroprotective therapy.
Methods: A cross-sectional study was conducted in Lahore over five months, including 100 adult participants divided equally between NSAID users with gastroprotective therapy (n=50) and those without (n=50). Inclusion criteria required at least three months of continuous NSAID use. Patients underwent upper gastrointestinal endoscopy, and findings were classified using the Updated Sydney System. Data regarding Helicobacter pylori infection were also collected. Statistical analysis was performed using independent t-tests, chi-square tests, and logistic regression, with p<0.05 considered significant.
Results: The mean age of participants was 49.8 ± 11.2 years in the gastroprotection group and 50.4 ± 10.9 years in the non-protection group. Normal gastric mucosa was observed in 40% of those with gastroprotection compared to 16% without. Erosive gastritis was identified in 18% versus 36%, and peptic ulcer in 10% versus 20% respectively. Severe mucosal lesions were significantly more common in the non-protected group (18%) compared to the gastroprotected group (6%). Logistic regression confirmed that absence of gastroprotective therapy was an independent predictor of mucosal injury after adjusting for confounders.
Conclusion: Gastroprotective therapy substantially reduced the frequency and severity of gastric mucosal injury among chronic NSAID users. These findings support routine incorporation of preventive therapy to minimize NSAID-induced gastropathy.
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Copyright (c) 2025 Sawera Tahir, Muhammad Hassan Laique, Offisa Kausar, M Arslan Liaqat, Shahid Ullah, Zarish Patrus, Abdul Wahab Ali (Author)
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